Trigeminal neuralgia causes facial pain.Trigeminalneuralgiadevelops in mid to late life. The condition is the most frequently occurring of all the nerve pain disorders. The pain, which comes and goes, feels like bursts of sharp, stabbing, electric-shocks. This pain can last from a few seconds to a few minutes.

People with trigeminal neuralgia become plagued by intermittent severe pain that interferes with common daily activities such as eating and sleep. They live in fear of unpredictable painful attacks, which leads to sleep deprivation and undereating. The condition can lead to irritability, severe anticipatory anxiety and depression, and life-threatening malnutrition. Suicidal depression is not uncommon.

Causes

The condition has no clear-cut cause.

• Some experts argue that the syndrome is caused by traumatic damage to the nerve as it passes from the openings in the skull to the muscles and tissue of the face. The damage compresses the nerve, causing the nerve cell to shed the protective and conductive coating (demyelination).
• Others believe the cause stems from biochemical change in the nerve tissue itself.
• A more recent notion is that an abnormal blood vessel compresses the nerve as it exits from the brain itself.

In all cases, though, an excessive burst of nervous activity from a damaged nerve causes the painful attacks

Symptoms

A defining feature of trigeminal neuralgia is the trigger zone-a small area in the central part of the face, usually on a cheek, nose, or lip, that, when stimulated, triggers a typical burst of pain.

• A light touch or vibration is the most effective trigger.
• Because of this, many common daily activities trigger the attacks. Washing your face, brushing your teeth, shaving, or talking Common sensations such as having wind hit your face Eating and chewing

Many people avoid food and drink rather than experience the severe pain.

• These people risk weight loss and dehydration, a leading cause of hospitalization in this group.
• People frequently require hospitalization for rapid pain control when their trigeminal neuralgia becomes unmanageable at home.

Between attacks, most people remain relatively pain-free. A subgroup, however, experience a dull ache between attacks, suggesting physical compression of the affected nerve, either by a blood vessel or some other structure

When to Seek Medical Care

Contact your doctor when you begin to have these pains.
It is essential you see a doctor familiar with the care of patients with trigeminal neuralgia early on to help prevent the development of more severe complications.
It is especially important to work with your doctor because with appropriate drug therapy trigeminal neuralgia can almost always be controlled.

Seek immediate medical attention or go to a hospital's Emergency Department under the following circumstances:

When your current medication does not control the pain and you need immediate relief
When your pain prevents eating and drinking and places you at risk for malnutrition or dehydration
When you experience profound side effects of your medication such as severe drowsiness, sedation, nausea, or vomiting
When a doctor advises you to seek evaluation and treatment for any of these problem

Exams and Tests

Your doctor must rule out a variety of other causes of facial pain besides trigeminal neuralgia, including various unusual forms of headache.

• Atypical neuralgia
• Myofascial pain
• Temporomandibular facial pain
• Cluster headaches
• Local disease in the sinuses, jaw, throat, and bones of your head

Physical examination of the head will help define other possible causes of this painful syndrome. Physical findings in people with trigeminal neuralgia are normal.
A doctor should complete an initial neurological examination to determine the presence of other conditions, such as multiple sclerosis, that are associated with nerve pain syndromes like trigeminal neuralgia.
Doctors reserve more extensive testing, such as a CT scan or MRI of the head, for people in whom they suspect an associated condition, such as skull or brain tumor, infection, or neurological condition

Trigeminal Neuralgia Treatment Self-Care at Home
Because the pain stems from nerves deep inside your skull, no home remedy is effective

Treatment with out surgery:

Pain specialists use invasive therapy, including nerve blocks, nerve destruction, and nerve decompression techniques, as well as drug therapy to treat trigeminal neuralgia.
In some instances, a single injection, or a series of injections, or perhaps one decompressive procedure, will reduce or eliminate the pain and prevent your need for a long course of drug therapy.
Injection techniques also can relieve unremitting pain instantly and further confirm the diagnosis. Using real-time x-rays, doctors can target the anatomical origin of the nerve deep in your skull. Then, with a fine needle, they can do one of the following to halt the painful syndrome:

• Inject that source with anesthetic and steroid.
• Inject that nerve with a drug used to destroy faulty cells.
• Temporomandibular facial pain

This procedure can be performed with surprisingly little discomfor

Surgery

If doctors clearly determine the cause of the disorder to be compression of an artery on the trigeminal nerve deep in your skull, a neurosurgeon can perform a microvascular decompression.
The surgeon moves the compressing artery to a location away from the compressed root of the nerve.
The major disadvantage is that it requires a neurosurgical operation-with all its complications-to get access to the root of the trigeminal nerve