UNDERSTANDING TRIGEMINAL NEURALGIA

Our health writer, Jackie Mitchell, finds out more about this condition.

TRIGEMINAL neuralgia is a condition that causes sudden attacks of pain on one side of the face. It rarely affects both sides and, even then, rarely at the same time.

The pain is often triggered by a light touch to an area of skin and can occur without warning.

“Some people may experience frequent attacks of pain, while others may have long periods of time free from pain, known as remission periods,” Eva Favva, from the Brain & Spine Foundation, says.

“Some may feel pain on the skin on their face or in their mouth and teeth.

“People use words such as ‘stabbing’, ‘shooting’ and ‘electric shock-like’ to describe the pain.

“It commonly affects the jaw and cheek, but might affect the whole side of the face.”

Various light touch activities can bring on the pain, such as cleaning teeth, applying make-up, eating, talking, laughing or smiling.

“People often have trigger points on their skin which bring on a sudden spasm of pain when touched,” Eva adds.

“The wind, a light breeze or air conditioning can also trigger attacks. Attacks can also occur without any trigger, known as spontaneous pain.”

The exact cause is unknown, but it’s thought the trigeminal nerve is “misfiring” and sending out inappropriate pain signs.

“Often the pain comes from a blood vessel pressing on the trigeminal nerve,” Eva explains.

“The pressure from the blood vessel damages the protective outer coating of the nerve (myelin sheath) and the nerve becomes sensitive.

“The myelin sheath can be damaged by pressure from blood vessels (veins or arteries), multiple sclerosis (MS), injury to the nerve or as part of the ageing process.”

You should consult your GP if you experience persistent or frequent facial pain, particularly if standard painkillers such as paracetamol and ibuprofen aren’t helping and a dentist has ruled out any dental causes.

“Most people will be prescribed medicine to help control their pain,” Eva says, “although surgery may be considered in the longer term where medicine is ineffective or causes too many side effects.”

It may also help to avoid triggers. For example, if the pain is triggered by cold weather, wear a scarf to keep your face warm when going out.

“We would also suggest looking after your mental wellbeing by discussing with a counsellor the impact of trigeminal neuralgia on your quality of life,” Eva adds.

“Keep a pain diary so you can identify any trigger factors.”

The Brain & Spine Foundation runs peer support groups and provides expert health information relating to neurological conditions.

The charity runs a helpline on 0808 808 1000 (Mon-fri, 9 a.m. to 4 p.m.) where you can talk to a neuroscience nurse.

Visit www.brainandspine.org.uk for more information. ■

Avoid triggers whenever possible