Trigeminal neuralgia


An uncommon form of facial pain which typically gives rise to severe, intermittent sharp pain, often described as ‘stabbing’ or ‘electric-shocks’.

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What is trigeminal neuralgia?

Trigeminal neuralgia is a severe and sudden type of facial pain. It's believed to be caused by an artery or vein compressing your trigeminal nerve (the nerve that gives feeling to the face). Other causes include tumours compressing the nerve, and multiple sclerosis which causes loss of the ‘insulation’ around nerve fibres.

There are two trigeminal nerves, one for each side of the face. They are each formed of three branches which give feeling to the forehead, cheek and jaw respectively. Those diagnosed with neuralgia experience pain only on one side of the face, usually in the cheek and/or jaw, with fewer patients suffering pain in the forehead and eye.

The neuralgic pain is not constant, but comes in waves or spasms, sometimes lasting for minutes at a time before easing off. In between attacks the victim is normally pain-free but fearful of talking, eating or otherwise triggering the next spasm. These attacks can lead to anxiety as well as actual pain. To help this, we offer a range of treatment options to improve your condition.

Need to know

The main symptom of trigeminal neuralgia is a severe, sharp-shooting pain in your jaw, teeth and gums. In some cases, the pain may also be felt in the forehead or eye. These attacks can be very intense and occur regularly.

Actions or movement that can trigger these symptoms include:

  • talking
  • smiling/laughing
  • chewing/swallowing
  • brushing your teeth
  • touching your face
  • washing your face

The severe pain you may feel from trigeminal neuralgia will help your consultant make a diagnosis. From their discussion with you, they will then likely undertake an MRI scan, to give a clear image of the trigeminal nerves.

An MRI scan can help your consultant to identify any abnormality around the nerve, particularly the proximity of an artery or the presence of a benign tumour in contact with the nerve.

Medication: The mainstay of treatment is medical, using a range of drugs which have been found to give either complete or partial relief. This may include anticonvulsant medication to block the pain transmission in the nerve. Your doctor can talk to you about the variety of medication available. 

Surgery: If medication fails to control the pain, or the side effects are too great, there are surgical options including:

  • Injections under general anaesthetic: A needle passed through the cheek and skull base into the trigeminal nerve using x-ray guidance
  • Cryotherapy: Freezing of the the nerves, using a probe cooled by liquid nitrogen, as they emerge from the skull to supply the face. This procedure is normally performed by Oral surgeons. The pain is often relieved for a period, but usually recurs as the nerves recover from the damage.
  • Microvascular decompression surgery: The most effective form of treatment. This is an operation to move an artery away from the trigeminal nerve. Although we are not certain that vascular compression causes neuralgia, the operation has a high chance of relieving pain long-term.
  • Gamma Knife radiosurgery: Where a high dose of radiation is delivered to the trigeminal nerve by a radiation beam which targets the nerve and damage the trigeminal nerve pain fibres.

Our Trigeminal neuralgia locations

London Neurosurgery Partnership

London Neurosurgery Partnership

78 Harley Street W1G 7HJ London
The Harley Street Clinic

The Harley Street Clinic

35 Weymouth Street W1G 8BJ London
The Portland Hospital

The Portland Hospital

205-209 Great Portland Street W1W 5AH London
The Lister Hospital

The Lister Hospital

Chelsea Bridge Road, SW1W 8RH London
The Shard Outpatients

The Shard Outpatients

The Shard, 32 St Thomas Street SE1 9BS London
London Bridge Hospital

London Bridge Hospital

27 Tooley Street SE1 2PR London

Patient stories

This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.