trigeminal neuralgia, facialnerve disease

Trigeminal neuralgia (also known as prosopalgia, tic douloureux or Fothergill's disease) is a chronic pain condition that affects the trigeminal nerve at the base of your brain, the nerve that carries sensation from your face to your brain. Mild stimulation of your face, such as brushing your teeth or putting on makeup, may trigger excruciating pain. The pain you experience may start as short, mild attacks, but the condition can progress to longer and more frequent bouts of intense pain.

Trigeminal neuralgia may include one or several of these patterns:
  • Occasional mild pain
  • Pain that may be extremely severe
  • Shooting pain
  • Jabbing pain
  • Electric shock pain
  • Pain lasting from a few to several seconds
  • Pain lasting days, weeks, months or even longer
  • Attacks that become more frequent and intense over time
  • Spontaneous attacks of pain triggered by touching the face
  • Spontaneous attacks of pain triggered by nothing
  • Pain affecting a single spot on your face
  • Pain affecting one side of the face at a time
  • Pain spread out across your face

Some causes of trigeminal neuralgia include contact between a blood vessel and the trigeminal nerve that causes the nerve to malfunction, degeneration that can happen as a result of aging, related to multiple sclerosis or a similar disorder that damages the myelin sheath protecting certain nerves and less commonly, caused by a tumor compressing the trigeminal nerve. 

Trigeminal neuralgia typically affects women more often than men and people who are older than 50.

Diagnosis of Trigeminal Neuralgia
To diagnose trigeminal neuralgia, our team will ask you to describe your pain symptoms, concentrating on the type of pain, the location and whether an event triggered the pain. Trigeminal neuralgia is normally diagnosed based on the description of your symptoms; no test can verify the presence of trigeminal neuralgia, but tests can help us rule out other causes.

We may conduct tests, including a neurological exam to figure out where the pain is occurring and whether a compressed nerve or other condition may be responsible. We can use magnetic resonance imaging (MRI) to discover whether a tumor or multiple sclerosis is irritating your trigeminal nerve. 

Treatment Options for Trigeminal Neuralgia
Trigeminal neuralgia can usually be managed with medications, injections or surgery. Our team will prescribe medications to lessen or block the pain signals sent to your brain, including anticonvulsants (carbamazepine, clonazepam, gabapentin) or antispasmodic agents (baclofen which can be used in conjunction with carbamazepine).

We can perform several surgical options to treat trigeminal neuralgia:
  • Microvascular decompression (relocating or removing in-contact blood vessels) 
  • Gamma knife radiosurgery (a focused dose of radiation to damage the nerve)
  • Glycerol-injection rhizotomy (an injection of sterile glycerol to damage the nerve)
  • Balloon-compression rhizotomy (insertion of a balloon in the area of the nerve and inflating it to damage the nerve)
  • Radiofrequency thermal lesioning (insertion of an electrode in the area of the nerve and introducing RF waves that cause heat which damages the nerve) 

If your condition is due to another disease such as multiple sclerosis, we will treat the underlying condition.


Our physicians at Houston Methodist specialize in managing facial nerve diseases at the following convenient locations.