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Trigeminal neuralgia (TN) is often described as the worst pain known to man. The intense pain occurs one’s head and though it is not fatal, it can be debilitating.

150,000 people every year receive a TN diagnosis. While most commonly occurring in individuals over 50 years old and women, the condition can happen anyone.

What is the trigeminal nerve?

The trigeminal nerve, the nerve associated with TN, is the cranial nerve that controls sensations in one’s face. There are two, one on the right side of the head and the other on the left. Each nerve has three branches, each controlling different parts of the face. One regulates the eye, upper eyelid and forehead, another controls the lower eyelid, cheek, nostril, upper lip and upper gum, and the final connects to the jaw, lower lip and lower gum.


TN is the result of pressure on the trigeminal nerve that causes it to misfire. This can be through contact between the trigeminal nerve and an artery or vein. Potential causes for TN are:

  • Malpractice during surgery, commonly dental or sinus surgery
  • Facial trauma
  • Damage to myelin sheaths (substance around the nerve) from multiple sclerosis
  • Arteriovenous malformation, the tangling of surrounding arteries and veins that may compress the nerve
  • Pressure from a tumor
  • Stroke


The disorder results in incredible and sometimes spontaneous pain. While often confused for dental issues, surgery of this kind typically does not help.

Symptoms are diagnosed as one of two types. Type 1, also referred to classic TN, involves sharp pain, throbbing, shock-like symptoms triggered by contact to the area. This type is circular, with periods of no pain, which typically shorten over time. Type 2, or atypical TN, involves constant, burning pain with less or no remission periods.

Symptoms triggers can be:

  • Touching the skin or surrounding facial area, including activities such as brushing teeth, applying makeup and shaving
  • Drinking hot or cold beverages
  • Wind on the face
  • Smiling
  • Talking


Treatment for TN typically involves medications for pain relief, the most common being carbamazepine.

For some, though, medication does not help. There are other medical options for treatment, including:

  • Microvascular decompression, moving the compressing factor away from the nerve, through open surgery to the skull
  • Surgery using heat to destroy the nerve fibers that are misfiring
  • Glycerol injections to the nerve to damage the affected nerve
  • Balloon compression, where a balloon is inserted through a needle, presses on the nerve and injures the misfiring fibers
  • Stereotactic radiosurgery, which targets the nerve with radiation to interrupt pain signals

Trigeminal neuralgia, while sometimes naturally occurring, can be the result of medical malpractice. If you are diagnosed with TN after a surgery, you should consult an experienced attorney. There are also many support groups that can be helpful in understanding, treating and dealing with your chronic pain.