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Trigeminal Neuralgia Trigeminal Neuralgia Trigeminal Nerve (Cranial Nerve V) and Its 3 Regions of Innervation Acial Pain Has a Number of Causes

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JAMA PATIENT PAGE The Journal of the American Medical Association NEUROLOGY Trigeminal Neuralgia Trigeminal neuralgia Trigeminal nerve (cranial nerve V) and its 3 regions of innervation acial pain has a number of causes. Trigeminal neuralgia (TN) is named for the nerve (the trigeminal, or fifth cranial nerve) Fthat is affected. Trigeminal neuralgia causes brief, intense, BRAIN severe pain, usually on one side of the face or the jaw or near the V eye. Trigeminal neuralgia is a type of neuropathic pain (pain caused 1 by nerves). V V 2 Trigeminal neuralgia is more common in people older than 50 years 3 and tends to affect women more than men. It may occur in other family members. Researchers think that TN is caused by pressure on the trigeminal nerve from a blood vessel. Persons with TN may be treated by neurologists, medical doctors who specialize in the treatment of conditions affecting the nerves and the brain. BRAIN SYMPTOMS • Pain is sharp and can last a few seconds to several minutes. It often V feels like an electric shock or stabbing but may feel like burning. 1 There is no associated fever or swelling because it is not caused by Artery compressing trigeminal nerve and branches an infection. • Pain may be triggered by simple actions such as chewing, brushing V2 the teeth, puffs of air or wind on the face, or touching the face. V V 3 • Episodes can come and go, sometimes with a long time between 3 episodes (remission). The longer a person has TN, the shorter the V1 remission periods. Some individuals have nearly constant episodes. V • Because TN is chronic, unpredictable, and often severely painful, 2 persons may also have depression or anxiety. DIAGNOSIS FOR MORE INFORMATION Trigeminal neuralgia is usually diagnosed by a medical history and physical • National Institute of Neurological examination. Other causes of facial pain should be considered because they may Disorders and Stroke be treatable. Imaging studies such as magnetic resonance imaging (MRI) are often www.ninds.nih.gov helpful to exclude other causes of facial pain. • American Academy of Neurology www.aan.com TREATMENT INFORM YOURSELF • Although TN is not curable, it can usually be managed like any chronic medical condition. It is not fatal. To find this and previous JAMA • Antidepressant medications and antiseizure medications are often prescribed for persons Patient Pages, go to the Patient Page with TN because they often improve neuropathic types of pain. Narcotic pain medication Index on JAMA’s website at tends not to be helpful. www.jama.com. Many are available in • It may help to avoid things that trigger the pain. English and Spanish. A Patient Page • If severe TN is not manageable with medications, consultation with a neurosurgeon may on pain management was published be recommended. A neurosurgeon is a doctor who specializes in surgery of the nerves, in the November 12, 2003, issue. the brain, and the spinal cord. Medical devices or specialized surgeries may be offered to Sources: National Institute of Neurological Disorders persons with severe TN. and Stroke, American Academy of Neurology The JAMA Patient Page is a public service of JAMA. The information and recommenda- Janet M. Torpy, MD, Writer tions appearing on this page are appropriate in most instances, but they are not a substi- tute for medical diagnosis. For specific information concerning your personal medical Jennifer Lee Rogers, Illustrator Intern condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Robert M. Golub, Editor To purchase bulk reprints, call 312/464-0776. 1058 JAMA, March 13, 2013—Vol 309, No. 10 ©2013 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/23/2021.
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