Located in the head, the trigeminal nerve is one of the 12 cranial nerves – all with different and important roles in vision, hearing and controlling the function of facial muscles. The trigeminal nerve provides feeling to most of the face and mouth. Some problems with the nerve, such as trigeminal neuralgia, can be associated with pain.
Due to its size and placement, it is possible for the trigeminal nerve to be damaged during trauma, from the growth of tumors or from infections. It also can be injured during surgical procedures such as fracture repairs, orthognathic surgery, oncological surgery, cosmetic surgery or wisdom teeth extractions.
Patients can work with an oral and maxillofacial surgeon to manage trigeminal nerve damage problems through both surgical and non-surgical means.
Trigeminal Nerve Pain
Symptoms of trigeminal nerve pain can vary, and triggers of those symptoms may be inconsistent or vary from person to person. Potential signs of trigeminal nerve pain include:
- Seemingly spontaneous attacks of shooting or stabbing facial pain.
- Facial pain triggered by speaking, chewing, brushing teeth or simply touching the face.
- Constant aching or burning feelings that can evolve into spasm-like pain.
- Pain in the cheek, jaw, gums, teeth and lips (occasionally pain in an eye or the forehead).
- Attacks that increase in frequency and intensity over time.
While some patients may experience near-constant pain, others can experience long stretches of pain-free time. Trigeminal nerve pain typically affects one side of the face at a time.
Trigeminal Nerve Diagnosis & Treatments
Due to the broad trigeminal nerve functions, trigeminal nerve pain can have a significant impact on a patient’s quality of life. Significant pain can be caused by everyday behaviors such as chewing or by a light breeze crossing the face. An OMS can often diagnose trigeminal nerve pain based on a patient’s description of the pain, particularly the type and location of pain as well as what triggers the pain.
From there, an OMS may conduct a neurological examination or have an MRI ordered to determine if there is a specific underlying cause of trigeminal neuralgia or a sharp pain that follows length of the nerve. Trigeminal nerve treatment often begins with medications, including:
- Anticonvulsants
- Antispasmodic agents
- Neurotoxin injections (e.g., Botox)
While medication allows some patients to manage their trigeminal nerve pain, others may require surgical treatments from a multidisciplinary team, including:
- Microvascular decompression: Relocating or removing blood vessels in contact with the trigeminal nerve can reduce pressure on the nerve.
- Gamma Knife: A focused dose of radiation can damage the trigeminal nerve and reduce or eliminate nerve pain.
- Rhizotomy: Destruction of nerve fibers through thermal lesioning, balloon compression or glycerol injection.