If you're dealing with sharp, shock-like facial pain, you don't have to just endure it. At Mir Neurology, our board-certified neurologists diagnose and treat trigeminal neuralgia and other facial pain conditions for patients across Western Maryland, the Eastern Panhandle of West Virginia, and South-Central Pennsylvania.
Request an Appointment or call (301) 797-7600.
What Is Trigeminal Neuralgia?
Trigeminal neuralgia (TN) is a chronic pain condition affecting the trigeminal nerve, which carries sensation from your face to your brain. When this nerve misfires, it causes episodes of sudden, severe, electric shock-like pain on one side of the face.
The pain is so intense that TN has earned the nickname โthe suicide diseaseโ โ but it's important to know that effective treatments exist, and there is real reason for hope.
Trigeminal Neuralgia Symptoms
The pain of trigeminal neuralgia is distinctive. Common features include:
- Sudden, severe, shooting or stabbing pain โ often described as an electric shock
- Pain on one side of the face โ usually the cheek, jaw, teeth, gums, or lips, and less often the eye and forehead
- Brief attacks โ lasting from a few seconds to a couple of minutes
- Episodes triggered by everyday actions โ such as touching the face, chewing, talking, brushing teeth, shaving, or even a light breeze
- Painful periods that come and go โ bouts may last days, weeks, or months, sometimes followed by pain-free intervals
- Pain that tends to worsen over time if untreated
Because the pain can center on the teeth or jaw, trigeminal neuralgia is sometimes mistaken for a dental problem โ and people may have dental work before the true cause is found.
What Causes Trigeminal Neuralgia?
Trigeminal neuralgia most often occurs when a blood vessel presses against the trigeminal nerve near the brainstem, wearing away its protective coating and causing the nerve to misfire.
Other causes and contributors include:
- A blood vessel compressing the nerve, which is the most common cause
- Multiple sclerosis, which can damage the nerve's protective covering
- A tumor pressing on the nerve, which is less common
- Injury to the nerve from trauma, surgery, or other causes
- Aging, as trigeminal neuralgia is more common in older adults
Identifying the underlying cause is part of a complete evaluation, because it can affect the treatment approach.
How Is Trigeminal Neuralgia Diagnosed?
There's no single blood test for trigeminal neuralgia โ diagnosis is based mainly on your description of the pain. An evaluation typically includes:
Pain History
A detailed review of the type, location, triggers, and pattern of your facial pain.
Neurological Exam
An exam to assess facial sensation and help rule out other causes.
MRI Imaging
Imaging may be used to look for a compressing blood vessel, signs of MS, or a tumor.
Accurate Diagnosis
TN responds to treatments that differ from those for other facial or dental pain.
Trigeminal Neuralgia Treatment
The good news is that trigeminal neuralgia is very treatable, and most people start with medication rather than surgery. Treatment options include:
- Medications โ certain anti-seizure medications, such as carbamazepine, are the first-line treatment and are very effective at calming the misfiring nerve. Other medications may be added or used as alternatives.
- Medication management over time โ finding the right medication and dose, and adjusting as needed, is something a neurologist manages closely.
- Procedures and surgery โ when medications aren't enough or stop working, several effective procedures can relieve pain, including microvascular decompression, rhizotomy procedures, and stereotactic radiosurgery such as Gamma Knife.
Is trigeminal neuralgia curable? While TN is often considered a chronic condition, many people achieve excellent, long-lasting pain control with medication, and surgical procedures can provide significant or complete relief for those who need them.
Other Facial and Nerve Pain We Treat
The trigeminal nerve isn't the only source of nerve pain. Our neurologists also evaluate and treat related conditions, including occipital neuralgia, other forms of neuralgia, and nerve-related facial pain. If you're not sure what's causing your pain, an evaluation can pinpoint it.
When to See a Neurologist
See a neurologist if you have recurring facial pain โ especially sharp, shock-like pain triggered by touch, chewing, or talking โ that isn't explained by a dental problem, or facial pain that keeps returning. Early diagnosis means earlier relief.
At Mir Neurology, our board-certified neurologists diagnose trigeminal neuralgia, manage medication for lasting pain control, and coordinate advanced treatment when needed. With offices in Cumberland and Hagerstown, expert care is close to home.
Serving Western Maryland & the Tri-State Area
With offices in Cumberland and Hagerstown, we provide trigeminal neuralgia and facial pain care for patients across the region.
Maryland
Cumberland, Hagerstown, LaVale, Frostburg, Cresaptown, Hancock, Williamsport, Smithsburg, Boonsboro
West Virginia
Martinsburg, Keyser, Romney, Berkeley Springs, Paw Paw
Pennsylvania
Waynesboro, Greencastle, Chambersburg, Mercersburg
Cumberland office: 924 Seton Dr Suite C, Cumberland, MD 21502 โ MonโSat, 7:30 AM โ 4:30 PM
Hagerstown office: 11110 Medical Campus Rd Unit 151, Hagerstown, MD 21742 โ MonโFri, 7:30 AM โ 5:00 PM
Frequently Asked Questions
What does trigeminal neuralgia feel like?
It causes sudden, severe, electric shock-like or stabbing pain on one side of the face, often triggered by light touch, chewing, talking, or brushing the teeth. Attacks are brief but intense and may come in bouts.
What kind of doctor treats trigeminal neuralgia?
A neurologist diagnoses and treats trigeminal neuralgia, manages medications, and coordinates surgical referral when needed. Because the pain can mimic a dental problem, a neurologist's evaluation helps confirm the true cause.
What is the first-line treatment for trigeminal neuralgia?
Anti-seizure medications such as carbamazepine are the standard first treatment and are highly effective for most people. If medication isn't enough, several procedures can relieve the pain.
Is trigeminal neuralgia curable?
Many people achieve excellent, lasting pain control with medication, and surgical procedures can provide significant or complete relief. While it's often a chronic condition, it is very manageable.
What causes trigeminal neuralgia?
Most often, trigeminal neuralgia is caused by a blood vessel pressing on the trigeminal nerve. It can also be related to multiple sclerosis, a tumor, or nerve injury.
Living With Severe Facial Pain?
You don't have to. Mir Neurology can diagnose trigeminal neuralgia and build a treatment plan for relief.