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Trigeminal neuralgia is an extremely painful condition involving parts of the face. It involves an inflammation of the fifth cranial nerve, which is divided into three segments. The fifth cranial nerve is also called the trigeminal nerve. The first segment of the fifth cranial nerve involves innervation of the forehead and upper face. The second segment of the fifth cranial nerve involves innervation to the area between the eyes and the upper lip. The third segment of the fifth cranial nerve involves innervation of the area on the lower cheek and lower jaw. Usually only one segment of nerve on one side of the body is affected at any given point in time.

The condition usually affects older adults but can affect younger people as well. It is exquisitely painful and made worse by talking or moving the muscles of the face. It can be a sharp, lancing pain of the facial area. There is no consistent cause of trigeminal neuralgia but it can be associated with brain swelling and abnormal blood vessels near the nerve. For example, an arteriovenous malformation can cause the disease to happen. Multiple sclerosis can be a triggering event for trigeminal neuralgia. Even a light touch to the affected area can trigger the brain.

The symptoms of trigeminal neuralgia include an extremely painful, sharp and electric spasm of the face that lasts several seconds or minutes. The pain is only found on one side of the face and can involve the eye, the cheek or the lower part of the face and jaw. The pain can be triggered by sounds or by light touch to the face.

The pain can be made worse when chewing, drinking liquids, brushing teeth, eating or shaving the face. It can be relatively steady or can come and go depending on what you are doing to your face.

The tests done for trigeminal neuralgia include a history and physical examination that is consistent with the condition. Tapping on the face can trigger the pain. An MRI of the face and head can rule out other problems besides trigeminal neuralgia. Doctors can do a test on the trigeminal nerve itself to see if it is conducting properly or if it is the cause of the pain.

Treatment of trigeminal neuralgia includes giving corticosteroids to shrink the inflammation of the nerve. It is given over a couple week period of time. Anti-epilepsy drugs such as phenytoin, gabapentin and carbamazepine can be done to settle the activity of the nerve. Migraine medications such as sumatriptan can relax the pain. Tricyclic antidepressants, such as amitriptyline or nortriptyline, have an effect on trigeminal neuralgia. In some cases, surgery is required to lessen the pressure on the fifth cranial nerve. If surgery is done, it cuts or destroys part of the trigeminal nerve, which leads to numbness of the nerve. Stereotactic radiosurgery can be done. Surgery can also remove the blood vessel or tumor that is putting pressure on the affected portion of the nerve. Muscle relaxants such as baclofen or clonazepam can settle the inflammation of the nerve.

The prognosis or outlook for the condition can be poor or excellent, depending on the cause. Most young people with the disorder resolve the condition within a few weeks or months. If there is a tumor or blood vessel causing the trigeminal neuralgia, the prognosis depends on whether or not you have surgery to correct the problem. The pain may remain constant or severe in a small number of patients who need pain medication just to get by in the disease. If there is no underlying problem, there is a good chance of at least partial recovery.

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Our personal injury solicitors operate a specialist medical negligence compensation service. Our Trigeminal Neuralgia solicitors deal with claims using a no win no fee arrangement which means that if you don�t win then you don�t pay them their professional costs. If you would like legal advice at no cost with no further obligation just complete the contact form or email our lawyers offices or use the helpline and a Trigeminal Neuralgia solicitor will review your medical negligence compensation claim and phone you immediately.

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here