What Is Trigeminal Neuralgia?
Trigeminal neuralgia (TN), sometimes called tic douloureux, is a chronic pain condition that affects the trigeminal nerve—one of the most widely distributed nerves in the head. TN causes sudden, severe, shock-like or stabbing pain, typically on one side of the face.
Episodes can last from seconds to minutes and may occur in clusters, sometimes dozens of times per day. Over time, pain may become more persistent or difficult to manage.12
Causes of Trigeminal Neuralgia
Most cases of TN result from compression of the trigeminal nerve root by a nearby blood vessel, which damages the protective coating (myelin sheath) and disrupts normal nerve signaling.34 Other possible causes include:
- Multiple sclerosis (MS) – demyelination from MS can lead to nerve dysfunction and facial pain
- Tumors, cysts, or structural abnormalities pressing on the nerve
- Stroke or nerve trauma
- Unknown causes (idiopathic cases), which may still respond to treatment
Symptoms of Trigeminal Neuralgia
The hallmark symptom is intense facial pain on one side, commonly affecting the cheek, jaw, lips, or around the eye. Patients may describe the pain as:
- Stabbing, electric shock–like, or burning
- Triggered by talking, eating, brushing teeth, or even light touch
- Short-lasting but recurring frequently (or becoming constant over time)
- Sometimes accompanied by facial twitching during attacks5
This condition can be confused with cluster headaches, tooth pain, or other forms of neuropathy, but its distinct patterns help guide diagnosis.
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Diagnosing Trigeminal Neuralgia
At DFW Spine & Pain Institute, we diagnose TN based on:
- Detailed symptom history – including frequency, triggers, and nature of the pain
- Neurological examination
- MRI or other imaging to rule out structural causes like tumors or multiple sclerosis lesions
Early diagnosis is key to managing pain and maintaining your quality of life.
Treatment Options for Trigeminal Neuralgia
Medication Management
- Anticonvulsants are often the first line of treatment. These drugs—such as carbamazepine and oxcarbazepine—help calm overactive nerve signals.
- Other options may include gabapentin, pregabalin, or muscle relaxants.
- While medications are effective for many, they can cause side effects like drowsiness, dizziness, or nausea.
Minimally Invasive and Surgical Options
When medications are ineffective or no longer tolerated, we offer targeted, advanced interventions.
Radiofrequency Ablation
Also called rhizotomy, this procedure uses heat to create a small lesion on the nerve, disrupting pain signals. Relief is typically immediate and may last months or years.
Balloon Compression
A minimally invasive procedure in which a small balloon is inflated near the trigeminal nerve root to intentionally compress the nerve. This disrupts pain fibers while preserving touch sensation.
Stereotactic Radiosurgery (Gamma Knife®)
A non-surgical option that uses highly focused radiation to damage the trigeminal nerve root without making an incision. It’s ideal for patients who aren’t candidates for traditional surgery.
Microvascular Decompression (MVD)
For eligible patients, microvascular decompression can offer long-term relief. This neurosurgical procedure relieves pressure from a blood vessel pressing on the nerve by repositioning it and placing a protective pad. Unlike ablative procedures, MVD preserves nerve function.
Advanced and Adjunctive Therapies
When traditional medications and procedures don’t provide sufficient relief, DFW Spine & Pain Institute also offers:
- Ketamine Infusion Therapy – modulates central pain pathways for treatment-resistant nerve pain
- Magnetic Peripheral Nerve Stimulation (mPNS) – non-invasive therapy to calm irritated facial nerves
- Transcranial Magnetic Stimulation (TMS) – brain-based therapy for central pain and comorbid symptoms
- BOTOX® Injections – helpful in select cases of facial pain with muscular involvement
- Spinal Cord or Peripheral Nerve Stimulation – rarely used, but may benefit patients with complex, unresponsive facial neuropathy
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If you’re suffering from trigeminal neuralgia, DFW Spine & Pain Institute is here to help. Our experienced pain specialists offer advanced trigeminal neuralgia treatment in Dallas, Fort Worth, Plano, Frisco, and surrounding areas. Whether you’re newly diagnosed or searching for alternatives after years of chronic pain, we’ll work with you to develop a treatment plan focused on lasting pain relief.
Don’t let stabbing, electric shock–like pain control your life. Schedule a consultation today and take the first step toward comfort, clarity, and confidence.
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FAQs About Trigeminal Neuralgia
What triggers TN attacks?
Common triggers include chewing, speaking, brushing your teeth, shaving, or even a breeze across the skin. Some patients experience spontaneous attacks without any clear cause.6
Can TN go away on its own?
Episodes may subside temporarily, but the condition typically progresses without treatment. Pain can become more frequent or more intense over time.
Is TN more common in women?
Yes. Trigeminal neuralgia affects women more often than men and is most commonly diagnosed after age 50.
What if medications don’t work?
If anticonvulsants or other drugs aren’t effective or cause unwanted side effects, we offer a range of minimally invasive and surgical options to target pain directly at the source.
Is trigeminal neuralgia a form of neuropathy?
Yes—it’s a type of cranial neuropathy that affects the sensory pathway of the trigeminal nerve. It’s one of the most severe and painful forms.
