Trigeminal neuralgia is a nerve disorder that causes a stabbing or electric shock-like pain in parts of the face.
The pain comes from the trigeminal nerve, the major sensory nerve of the face and surrounding areas, and one of the largest nerves in the head. This nerve is responsible for sending impulses of touch, pain, pressure and temperature to the brain from the face, jaw, gums and tongue. Injuries to the trigeminal nerve can sometimes result from dental treatments such as dental injections, root canals, insertion of dental implants, removal of teeth or other surgical treatments.
This condition can be extremely distressing for patients. Although most patients regain normal sensation and function within a few weeks or months, some are left with abnormal sensation or pain, which can cause problems with speech and chewing.
Symptoms of trigeminal neuralgia include:
To confirm the diagnosis of trigeminal neuralgia and exclude other treatable causes of face pain, you will undergo a neurologic evaluation, an MRI of the head, or both. Your doctor will also evaluate the severity of your pain, your general medical condition, and your treatment goals versus risk aversion.
Medication management is always the first line of treatment for trigeminal neuralgia. Patients who continue to experience pain despite the best medical management will be evaluated for surgery. Our surgeons offer a variety of surgical approaches, listed below.
Microvascular decompression (MVD), also known as the Janetta procedure, is the most common surgical procedure for treating trigeminal neuralgia. In the procedure, the surgeon makes a small incision behind the ear and drills a small hole in the skull. Using microscopic visualization, the trigeminal nerve is exposed. In most cases, there is a blood vessel — typically an artery, but sometimes a vein — compressing the trigeminal nerve. By moving this blood vessel away from the nerve and interposing a padding made of Teflon felt, the pain is nearly always relieved.
Reviewed by health care specialists at UCSF Medical Center.