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Trigeminal Neuralgia

Trigeminal neuralgia or tic douloureux is a pain condition involving the fifth cranial nerve (trigeminal nerve). It is frequently described as a sudden severe pain like an electric shock in the jaw, teeth, or gums. The pain is sudden and can last anywhere from a few seconds to approximately two minutes and suddenly stops. Although it is a severe and debilitating pain, there are effective medical and surgical treatments.  

Signs and Symptoms:

Typical trigeminal neuralgia causes sharp, sudden electric shock-like pains along the fifth cranial nerve. Other trigeminal neuralgia symptoms include: 

  • Intense pain lasting seconds to minutes triggered by certain routine activities that stimulates the nerve such as shaving, brushing teeth, and chewing. 
  • Pain that usually eases at night-time and rarely wakes you from your sleep.
  • The pain typically goes through period of remission and may recur months or years later.  

Causes:

Trigeminal neuralgia is usually caused by pressure on the trigeminal nerve close to where it enters the brain stem. This condition usually occurs spontaneously but can be associated with facial trauma or dental procedures.

Diagnosis

As there is no specific diagnostic test for trigeminal neuralgia and the diagnosis is primarily based on history and examination. Trigeminal neuralgia presents similar to other oral and facial pains including toothache. It is critical that sinister underlying pathology is excluded.  Given the complex presentation of trigeminal the diagnosis can be delayed or even misdiagnosed.

When to see a doctor?

If you have oral and facial pain consistent with trigeminal neuralgia, it is critical to consult your doctor or dentist. The need to seek this care is especially important if pain medications are ineffective and your dentist has ruled out dental pain.  

 

To consult an Oral Medicine Specialist for facial pain that you feel might be undiagnosed trigeminal neuralgia, ask your doctor or dentist to refer you to TeleOralMedicine. 

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