Trigeminal Neuralgia

The sudden and severe facial pain that occurs in people with trigeminal neuralgia can affect every aspect of their life. Marcie Merson, MD, of Palm Beach Pain Institute in Delray Beach, Florida, is a pain management specialist who treats trigeminal neuralgia. She customizes plans that can restore health and happiness and relieve pain. Call the office or request an appointment online today to learn how Dr. Merson can help with your trigeminal neuralgia pain.

What is trigeminal neuralgia?

Trigeminal neuralgia is a chronic pain condition that causes sudden and severe facial pain. The pain may last a few seconds or minutes and come and go throughout the day. For some people, the pain is constant and worsens over time. 

The type of pain sensations you may have with trigeminal neuralgia include:

• Sudden, severe stabbing, burning, or aching in the cheek or jaw 
• Numbness or tingling
• Electric shock-like jolts of pain
• Burning sensation on one side of the face

Normal activities may trigger the pain, like brushing your teeth, eating or drinking, or putting on makeup.

Trigeminal neuralgia can develop at any age, but it’s more common in people over 50. 

What causes trigeminal neuralgia?

Trigeminal neuralgia has many possible causes. The pain condition involves the trigeminal nerve, which is one of the cranial nerves and a sensory nerve for the face. 

Dental trauma is a common cause of trigeminal neuralgia.  Tooth extractions can create trauma to the nerves and the bone structure of the face.  

Herpes Zoster is a common infectious cause of trigeminal neuralgia.  It can occur in all 3 divisions of the trigeminal nerve.

Another common cause is pressure on the nerve from a blood vessel at the base of the brain. Tumors or lesions may also compress the nerve and cause pain. 

People who have multiple sclerosis (MS) are at risk of developing trigeminal neuralgia because of how the disease affects the myelin sheath that covers and protects nerves.

Sometimes, the underlying cause of trigeminal neuralgia is unknown. 

What tests diagnose trigeminal neuralgia?

No single test can diagnose trigeminal neuralgia. Unfortunately, many conditions cause facial pain, like migraines and temporomandibular joint (TMJ) syndrome. Dr. Merson conducts a thorough evaluation to identify the root cause of your pain.

She asks detailed questions about your symptoms, where they occur, and the activities that trigger them. She reviews your medical history and performs a physical and neurological exam. 

You may also request an MRI scan of the head to look for nerve compression from a blood vessel or tumor. 

What treatments help manage trigeminal neuralgia?

Dr. Merson talks to you about your diagnosis and treatment options. Initially, she prescribes medications to help with pain, such as:

• Anticonvulsants to block pain signals including Gabapentin and Lyrica
• Antispasmodic agents to prevent muscle spasms
• Tricyclic antidepressants for pain 
• Osteopathic Treatment
• Botox® injections to block pain signals

If medications fail to provide relief from your trigeminal neuralgia symptoms, Dr. Merson may recommend Osteopathic treatment as well as nerve blocks.

If necessary, in severe, refractory cases, Dr. Merson may refer you to a neurosurgeon to discuss surgical options. 

Call Palm Beach Pain Institute or book an appointment online today to learn more about treatment for trigeminal neuralgia.