The Shocking Truth About Facial Pain: When to Suspect Trigeminal Neuralgia

When the American Association of Neurological Surgeons refers to a condition as “the most excruciating pain known to humanity,” you get an idea about how severe it is. The condition they’re referring to is trigeminal neuralgia, which, thankfully, isn’t all that common — there are about 150,000 new diagnoses of trigeminal neuralgia in the United States each year. 

If you’re dealing with facial pain and you want to get to the bottom of it, you’re in the right place. At our practice, Dr. Ali H. Mesiwala is a leading neurosurgeon, and he and his team have extensive experience helping patients get to the other side of trigeminal neuralgia pain.

In the following, we look at what causes trigeminal neuralgia, key signs of the condition, and how we can bring you much-needed relief.

Trigeminal neuralgia — a matter of nerve compression

Much of your peripheral nervous system is comprised of nerve roots that exit your spine to create a vast network of sensory, motor, and autonomic nerves. The nerves above your neck, however, are more direct and come from 12 cranial nerves that service your head and face. 

The largest of these nerves is your trigeminal nerve, which provides much of the sensory information around your face. The nerve also helps with chewing.

When something presses on the trigeminal nerve, it can lead to the symptoms that are hard to ignore (we’ll get into these in a minute). In 80% to 90% of cases of trigeminal neuralgia, that “something” is a blood vessel in the brain that’s pressing against the cranial nerve, usually the superior cerebellar artery.

Signs of trigeminal neuralgia

Now, let's get into the hallmarks of trigeminal neuralgia, which are impossible to ignore. In most cases, people experience sudden attacks of excruciating pain, usually on one side of the face.

This pain is often triggered by touching or moving your face, and the pain can last for seconds or minutes. In between these painful attacks, you can experience periods of relief, but some people report ongoing throbbing or aching in the face. 

Getting relief from trigeminal neuralgia

As you might imagine, given the symptoms, seeking relief is a top priority for anyone who's suffering from trigeminal neuralgia. To start, we can place you on pain medications, such as anti-convulsants, to make you more comfortable.

From there, we do some investigative work to ensure we have the right diagnosis. Trigeminal neuralgia can mimic other painful conditions, such as an abscess in your tooth, an issue in your sinuses, or shingles.

If we find that you do have trigeminal neuralgia, it’s important to note that the issue usually doesn't go away on its own. 

Though some people can manage the symptoms well with medications, others find that this approach falls short. The good news in these cases is that several surgical solutions are quite effective, including:

Microvascular decompression 

This is a procedure in which Dr. Mesiwala moves the blood vessel that’s pressing up against the nerve.

Rhizotomoy

Dr. Mesiwala ablates the nerve root to disrupt the pain signaling.

Peripheral neurectomy

Dr. Mesiwala destroys or removes a piece of the trigeminal nerve.

Radiosurgery

We direct radiation into damaged portions of the trigeminal nerve.

We also offer neuromodulation, a less invasive technique in which we modulate the nerve’s activity to reduce pain signaling.

The bottom line is that if you're struggling with trigeminal neuralgia, you must get an experienced neurologist and neurosurgeon on the case, such as our own Dr. Mesiwala. To get the best care for your facial pain, please contact one of our offices in Newport Beach, Marina del Rey, or Rancho Cucamonga, California, today to schedule a consultation with Dr. Mesiwala.