About trigeminal neuralgia
The trigeminal nerve has three main branches that carry sensation from the forehead, cheek, and jaw. In trigeminal neuralgia, the nerve becomes irritable, often because a nearby blood vessel presses on it near the brainstem.
Attacks can be triggered by light touch, chewing, talking, brushing teeth, or a breeze on the face, and each jolt lasts seconds to a couple of minutes. Seek urgent care for facial numbness that is new, facial weakness, vision changes, or pain along with other neurologic symptoms, since these can signal a different problem.
Common symptoms
- Sudden, severe, electric or stabbing pain on one side of the face
- Attacks that last seconds and may come in rapid bursts
- Pain triggered by touch, chewing, talking, or brushing teeth
- Pain in the cheek, jaw, teeth, gums, lips, or around the eye
- Pain-free periods between flares
Common causes and risk factors
- A blood vessel pressing on the trigeminal nerve
- Multiple sclerosis, which can damage the nerve covering
- Rarely, a tumor or other growth pressing on the nerve
- Injury to the face or prior dental or facial surgery
How we diagnose it
Dr. Chen takes a careful history of the pain pattern and triggers and performs a neurologic exam of the face. MRI of the brain is usually recommended to look for a blood vessel pressing on the nerve and to rule out other causes. We coordinate with neurology and dental providers as needed.
How Propel treats trigeminal neuralgia
Medication is the usual first step, and many people get good control with anti-seizure medicines that calm overactive nerves. We work with your neurologist to find a dose that controls pain with tolerable side effects.
For flares or pain not fully controlled by medication, Dr. Chen may perform ultrasound-guided trigeminal nerve branch blocks or sphenopalatine ganglion blocks. When pain remains severe, we help coordinate referral for surgical options such as microvascular decompression.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about trigeminal neuralgia
- Is trigeminal neuralgia a dental problem?
- No, although the pain is often felt in the teeth or jaw and many people see a dentist first. It is a nerve condition, and dental work does not usually fix it.
- What is a trigeminal nerve block?
- A trigeminal nerve block places numbing medicine, sometimes with a steroid, around a branch of the trigeminal nerve. Using ultrasound, our physician can see the nerve and guide the needle precisely. Blocks can help control flares.
- Can trigeminal neuralgia go away on its own?
- Some people have long pain-free periods between flares, but the condition often returns. Treatment focuses on controlling attacks and keeping you comfortable with daily activities.