What is Trigeminal Neuralgia?

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which
carries sensation from your face to your brain. It is characterized by sudden, severe, electric
shock-like facial pain, usually on one side of the face. The pain can be triggered by simple
activities such as talking, brushing teeth, eating, or even light wind on the face.

Trigeminal neuralgia can be intensely painful and disabling, but with the right treatment,
many patients achieve significant relief.



Common Symptoms

  • Sharp, stabbing, or shock-like facial pain
  • Sudden attacks lasting seconds to minutes
  • Pain typically affecting one side of the face
  • Pain triggered by touch, chewing, speaking, or brushing teeth
  • Attacks may become more frequent and severe over time

When to Seek Help:

If you experience sudden, intense facial pain, consult a dentist promptly. Assessment by both a neurologist and oral surgeon is essential to rule out conditions like multiple sclerosis (MS), tumours, or dental issues. Early diagnosis and tailored treatment can significantly improve outcomes and quality of life. At PainClinicNI, we can assist if medications prescribed by your GP or neurologist have been ineffective or leading to intolerable side effects. We also provide nerve blocks to dampen down a flare-up.

Management of Trigeminal Neuralgia

Managing trigeminal neuralgia involves medications, interventional procedures, and in some cases, surgery. Each plan is tailored to the individual's condition and response to treatment.

Medications

  • Anticonvulsants (e.g., carbamazepine, oxcarbazepine) are often the first line of treatment.
  • Antidepressants such as Amitriptyline or Duloxetine may be used.

Medications

  • Anticonvulsants (e.g., carbamazepine, oxcarbazepine) are often the first line of treatment.
  • Antidepressants such as Amitriptyline or Duloxetine may be used.

Surgical Options (for severe cases and assessed via neuro surgeons):

  • Microvascular decompression (MVD) – relieves pressure on the nerve.
  • Trigeminal Ganglion ablation – selectively damages nerve fibres to reduce pain signals.
  • Gamma Knife radiosurgery – a non-invasive treatment using focused radiation (Leeds or Bristol, accessed via neuro surgeons)

Injection Therapies and Nerve Blocks:

  • Trigeminal nerve blocks can offer temporary relief by numbing the nerve.
  • Botox may be effective in certain cases, when medications and surgery hasn’t helped.
  • Stellate ganglion block is reserved for those patients, where there is an element of sensitisation and no actual cause is identifiable on imaging.

Injection Therapies and Nerve Blocks:

  • Trigeminal nerve blocks can offer temporary relief by numbing the nerve.
  • Botox may be effective in certain cases, when medications and surgery hasn’t helped.
  • Stellate ganglion block is reserved for those patients, where there is an element of sensitisation and no actual cause is identifiable on imaging.

Supportive Care

  • Lifestyle changes to avoid known triggers
  • Pain management counselling.
  • Emotional support for coping with chronic pain

Possible Causes and Triggers:

  • Nerve compression: Often caused by a blood vessel pressing on the trigeminal nerve near the brainstem
  • Multiple sclerosis: In some cases, nerve damage related to MS may cause symptoms
  • Post-surgical or traumatic injury: Facial nerve damage can trigger the condition
  • No known cause: In ½ of TN sufferers, no cause will be found. Increased nerve sensitivity (Central Sensitisation) is thought to be the underlying mechanism in those patients.
  • Triggers: Touch, chewing, shaving, cold breeze, or even smiling may provoke an attack

How Can We Help?

At PainClinicNI, we offer a comprehensive, evidence-based approach to low back pain. Our services include:
  • Detailed pain assessments
  • Medication optimisation
  • Peripheral Nerve blocks for controlling an acute flare-up
  • Botox for Trigeminal Neuralgia
  • Stellate ganglion block
“We aim to restore comfort and confidence, helping you live with less pain.”