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Facial Pain? It Could Be Trigeminal Neuralgia

Dec 13, 2023
Facial Pain? It Could Be Trigeminal Neuralgia
The pain that zaps through your face is excruciating and more than a little mysterious given there’s nothing on the surface that would account for such discomfort. It might be trigeminal neuralgia.

Seemingly out of nowhere, pain zaps through one side of your face. Or you develop hypersensitivity in your face and even the slightest touch can cause a miserable flare-up of pain.

If you’re experiencing facial pain and there’s nothing to account for the discomfort on the surface, our team here at Gill Neuroscience, under the direction of board-certified neurologist Dr. Paul Gill, wants to draw your attention to one potential culprit — trigeminal neuralgia.

Below, we look at the symptoms of this fairly uncommon condition — it affects between 4 and 13 people out of 100,000 — as well as why it occurs and how we can stop the pain.

Trigeminal neuralgia — pain like no other

The first thing to understand about trigeminal neuralgia is that it can be extremely painful. The American Association of Neurological Surgeons refers to the condition as “the most excruciating pain known to humanity.”

The pain is often described as:

  • Sudden and intense 
  • Shock-like
  • Burning
  • Aching
  • Throbbing

The pain typically occurs on one side of your face and lasts for a few seconds or a few minutes. The uncomfortable symptoms tend to develop in cycles that last for a few weeks, and then the symptoms quiet down again. 

During a flare-up, you can experience symptoms once a day or dozens of times an hour.

Trigeminal nerves cover a wide area

Trigeminal neuralgia is a condition that involves the fifth cranial nerve, which provides much of the sensation in your face and head. 

More specifically, your trigeminal nerves are a pair of nerves that start in your brain and then branch out on either side of your face to cover three areas:

  • The ophthalmic branch — supplies sensation to your scalp and forehead
  • The maxillary branch — provides sensation in your cheek, upper jaw, top lip, upper teeth and gums
  • The mandibular branch — services your lower jaw, bottom lip, lower teeth and gums

When you develop trigeminal neuralgia, your symptoms can develop anywhere in these areas, depending on where the nerve is damaged or compromised.

What causes the nerve pain in your face?

Up to now, we’ve described the pain and the nerves involved, but what exactly is interfering with this nerve? There are a few different culprits that can trigger trigeminal neuralgia, including:

  • A blood vessel that presses against the trigeminal nerve
  • Multiple sclerosis
  • A tumor
  • Injury to the nerve, such as during sinus surgery
  • Arteriovenous malformation — a bundle of blood vessels

The best way for us to figure out what’s behind the trigeminal neuralgia is through advanced imaging, such as an MRI, which can help us pinpoint where the trigeminal nerve is being affected.

Once we identify the nerve compression or damage, we can figure out next steps so you can get some relief. 

Certain medications, such as anti-seizure drugs, can help minimize the pain, and we usually start there. Once you're more comfortable, we can explore longer term solutions, such as surgery to free up the trigeminal nerve.


But let's not get too far ahead of ourselves. The most important step is to figure out what’s behind your facial pain so we can get you on the correct road to relief. To get started, call our office in Houston, Texas, at 832-912-7777, or use our online request form to schedule an appointment.