Neuralgia, trigeminal - Symptoms of trigeminal neuralgia

The main symptom of trigeminal neuralgia is sudden attacks of severe, sharp and shooting facial pain that last from a few seconds to about two minutes.

The pain is often described as an excruciating sensation, similar to an electric shock. The attacks can be so severe that you are unable to do anything during them, and the pain can sometimes bring you to your knees.

Trigeminal neuralgia usually only affects one side of your face. In rare cases it can affect both sides, although not at the same time. The pain can be in the teeth, the lower jaw, upper jaw, cheek and, less commonly, in the forehead or the eye.

You may feel aware of an impending attack of pain, though these usually come unexpectedly.

After the main, severe pain has subsided, you may experience a slight ache or burning feeling. There may also be a constant throbbing, aching or burning sensation between attacks.

You may have episodes of pain lasting regularly for days, weeks or months at a time. It is possible for the pain to then disappear completely and not recur for several months or years (a period known as "remission"). However, in severe cases, attacks may occur hundreds of times a day, and there may be no periods of remission.

Symptom triggers

Attacks of trigeminal neuralgia can be triggered by certain actions or movements, such as:

• talking
• smiling
• chewing
• brushing your teeth
• washing your face
• a light touch
• shaving or putting on make-up
• swallowing
• kissing
• a cool breeze or air conditioning
• head movements
• vibrations, such as walking or a car journey

However, pain can occur spontaneously with no triggers whatsoever.

Further problems

Living with trigeminal neuralgia can be extremely difficult, and your quality of life can be significantly affected.

You may feel like avoiding activities such as washing, shaving or eating to avoid triggering pain, and the fear of pain may mean you avoid social activities. However, it's important to try to live a normal life, and be aware that becoming undernourished or dehydrated can make the pain far worse.

The emotional strain of living with repeated episodes of pain can lead to psychological problems, such as depression. During periods of extreme pain, some people may even consider suicide. Even when pain-free, you may live in fear of the pain returning.

When to see your GP

You should see your GP if you experience frequent or persistent facial pain, particularly if standard painkillers such as paracetamol and ibuprofen do not help and a dentist has ruled out any dental causes.

Your GP will try to identify the problem by asking about your symptoms and ruling out conditions that could be responsible for your pain. Trigeminal neuralgia can be a difficult condition to diagnose, so it’s important to try to describe your symptoms as accurately and in as much detail as possible.

Read more about diagnosing trigeminal neuralgia.