Trigeminal neuralgia Mamae karioi ki te akaaka angaanga

We do not know the exact cause of trigeminal neuralgia, but it is thought to be caused by pressure (compression) or damage to the trigeminal nerve.

The trigeminal nerve can be compressed or damaged by:

• a blood vessel such as an artery or a vein — this is the most common cause
• a tumour or a cyst
• a degenerative nerve condition such as multiple sclerosis
• a facial injury
• surgery or a dental procedure.

You may be at higher risk of developing trigeminal neuralgia if you:

• have high blood pressure
• get migraines
• have a family history of trigeminal neuralgia.

Your trigeminal nerves control the feeling on each side of your face. Each nerve starts at your ear then divides into 3 branches:

• the ophthalmic, which supplies sensation to your forehead and nose
• the maxillary, which supplies your cheek above your mouth
• the mandibular, which supplies your jaw, your temple and in front of your ear.

Trigeminal neuralgia is when the nerve sends sudden severe electric-shock-like bursts of pain that you feel on one side of your face. The pain comes in waves or bouts and can occur hundreds of times a day, or just now and again.

Several things can trigger the pain, including:

• brushing your hair
• a breeze blowing on your face
• chewing food
• brushing your teeth
• talking.

The pattern of pain depends on which branch of your nerve is affected. If your ophthalmic branch is affected, you may also have a runny nose, tearing or redness in your eye.

Usually, the pain goes away when the attack is finished. Some people feel a dull ache that remains between attacks.

For most people, trigeminal neuralgia comes and goes in an unpredictable pattern over many years. This can mean days or months of spasms of pain followed by long periods without pain.

There are no tests for trigeminal neuralgia. Your healthcare provider can diagnose it by examining you and asking you about your symptoms.

They may want to do some tests to make sure your symptoms are not caused by other conditions. Sometimes they might refer you to get an MRI scan.

If you can avoid the things that trigger your pain, you could have fewer attacks, for example:

• if air blowing on your face is a trigger, sit away from open windows or wear a loose scarf around your head or a hoodie when outside on a windy day
• if chewing is a trigger, eat more softer foods.

Treatment for trigeminal neuralgia usually involves taking medication daily to reduce the painful messages that the nerve is sending to your brain.

Simple pain killers do not usually help trigeminal neuralgia. Your healthcare provider might prescribe you an anti-seizure medication. The one that is usually used is called carbamazepine, but there are others that your healthcare provider might try.

Carbamazepine — My Medicines

If you do not get better with medication, you may need surgery to remove pressure on the nerve. Talk to your healthcare provider about whether this might be an option for you.

Living with trigeminal neuralgia can affect your quality of life and be distressing. Talk through your feelings with your whānau and friends to get the support you need. You can also join a support group that shares information about trigeminal neuralgia.

Trigeminal Neuralgia Support New Zealand — Rare Disorders New Zealand