Chapter 2, Episode 8: What is Trigeminal Neuralgia?


This content has been medically reviewed by Richard Zimmerman, MD.

Trigeminal neuralgia is a neurological condition that causes a severe electric-shock like, shooting or stabbing facial pain, typically on one side. 

“Trigeminal” refers to the trigeminal nerve and “neuralgia” means nerve pathway pain. 

The trigeminal nerve is the largest of the 12 nerves originating deep in the base of the brain. It contains three branches that relay sensations between the brain and the face. It is also responsible for some of the motor functions of the face, mainly chewing.

Trigeminal neuralgia can be classified as “classical”, “secondary”, or “idiopathic”.

“Classical” trigeminal neuralgia is caused by compression of the trigeminal nerve by a neighboring blood vessel.

“Secondary” trigeminal neuralgia is caused by compression of the nerve by another underlying disease such as multiple sclerosis, a tumor or vascular malformation in the skull.

“Idiopathic” trigeminal neuralgia occurs when a specific cause is not found on neuroimaging or other testing.

In between attacks the pain can be continuous, near continuous or absent.

For some, trigeminal neuralgia pain is not triggered by anything but for others, activities like shaving, eating, wind exposure, applying makeup or any other movement that touches the face may trigger pain. 

Trigeminal neuralgia is often diagnosed after exclusion of other disorders such as cluster headache, post-shingles nerve pain, or temporomandibular disorders. An MRI is typically used to confirm the diagnosis.

First-line treatment should be carbamazepine, an anti-seizure medication. If necessary, other anti-seizure medications as well as muscle relaxers and various nerve pain medications may be used as an off-label treatment.

A neurosurgeon is often consulted to explain the various surgical options available for trigeminal neuralgia. One surgery commonly performed is a microvascular decompression which separates the trigeminal nerve from the compressing blood vessel. 

Due to the severe pain and disability experienced with this condition, a person should seek an experienced clinician to learn about the different medical and surgical options for trigeminal neuralgia. 

For more information, visit: or

This video is sponsored in part by Praxis.

*The contents of this video are intended for general informational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. AMD does not recommend or endorse any treatment, products, or procedures mentioned. Reliance on any information provided by this content is solely at your own risk.