If you have debilitating pain in your face or on your forehead that makes you scream in agony, you may have a medical condition called trigeminal neuralgia. In fact, trigeminal neuralgia has earned the title of the suicide disease in the medical community due to the excruciating pain the condition causes. Any small movement or sensation, such as brushing your teeth or a gust of wind on the face, can trigger the pain, which feels like the strike of a lightning bolt. Here's what you need to know about this condition, how it's diagnosed, and what you can do to treat it. 

Trigeminal Neuralgia

Trigeminal neuralgia is pain in the trigeminal nerve, which is the largest nerve in the head and called the fifth cranial nerve. This nerve has three branches, which is why it's also called the trigeminal nerve. The three branches cover three different regions in the face and forehead—ophthalamic, maxillary, and mandibular—as shown in this graphic. Trigeminal neuralgia can be caused by damage to the sensory fibers at the root of the trigeminal nerve, which may be attributed to trauma or multiple sclerosis, but sometimes the cause is unknown. 

Diagnosis & Treatment

Diagnosis for trigeminal neuralgia can be given after a thorough medical history and exam is done, typically by a neurologist or a neurosurgeon. While MRI imaging can show trigeminal neuralgia, MRIs are typically ordered to determine whether or not multiple sclerosis is causing the trigeminal neuralgia and to rule out any other conditions. The most common method of diagnosing the condition is by giving the patient an anticonvulsant medication to see if it has any affect on the pain. Anticonvulsant medication helps with trigeminal neuralgia due to the ability the medication has to block pain in the trigeminal nerve. 

If the medication works, then the patient can continue taking it as prescribed. However, it's important to have routine blood work done because the medication can damage the kidneys. If the medication does not work as effectively as needed, then microvascular decompression surgery may be necessary. In this surgery, small Teflon sponges are placed along the nerve where the neurosurgeon believes the nerve is being compressed or has been damaged.

The Teflon sponges act as a shock absorber to essentially cushion the nerve. In order to know the exact locations of concern, the neurosurgeon will order a comprehensive MRI of the head and neck with focus being on the base of the brain where the trigeminal nerve branches away from the medulla oblongata of the brain stem. 

Schedule your MRI imaging appointment today to help determine what is causing the pain in your face.