Trigeminal Nerve Inflammation: Symptoms and Signs

Facial pain that a person describes as an electric shock or a shooting pain in the jaw, teeth, or gums is often the result of trigeminal nerve damage. Let us explain how this nerve is structured, how neuritis differs from neuralgia, and by what signs inflammation is recognized. This material is for reference: it helps you understand what to discuss with a doctor, but it does not replace an examination.

What the trigeminal nerve is and what its inflammation means

The trigeminal nerve is one of the largest nerves of the head: it transmits sensations of pain and touch from the face, teeth, and oral cavity to the brain. Doctors more often speak not of "inflammation" in the everyday sense, but of neuralgia — a chronic condition with attacks of intense, shooting, or burning pain in the areas innervated by the nerve. The International Association for the Study of Pain defines it as sudden, brief, recurrent pains, usually on one side of the face. A primary form is distinguished, which occurs without other diseases due to compression of the nerve root, and a secondary form, caused by infection, a tumor, or multiple sclerosis.

Symptoms of trigeminal nerve inflammation

Attacks last from a few seconds to about two minutes and stop as suddenly as they began. The pain is more often unilateral and is usually felt in the lower part of the face; very rarely it affects both sides, but not simultaneously. In severe cases, attacks recur hundreds of times a day, and between them there may be no pain. Over time, some people develop a more constant aching, throbbing, or burning sensation. An attack is triggered by a light touch to the face — washing, eating, brushing teeth — as well as by wind, air conditioning, or head movement.

Signs of trigeminal neuritis and neuralgia: what the difference is

In reference books and colloquial speech these concepts are conflated, although they involve different mechanisms. The strictly described condition is trigeminal neuralgia; there are no separate signs of neuritis in the reference data. In neuralgia, the pain is paroxysmal and may be absent between attacks, and in some people a more constant burning later appears. The exact diagnosis is made by a doctor after an examination and questioning about the symptoms.

Why trigeminal nerve damage occurs

Up to 80–90% of cases are associated with compression of the nerve root by a tortuous or altered vessel at the point where it exits the pons of the brain, which leads to demyelination. Less often, the cause is a tumor, multiple sclerosis, or jaw trauma. Prevalence is estimated at approximately 1 case per 15,000 people; women are affected more often, onset usually occurs at the age of 50–60, and in people under 40 it is rare. Spasm of the facial muscles during an attack is called painful tic (French tic douloureux).

How it is diagnosed

There is no specific test for neuralgia, and recognition can be difficult: many diseases produce similar facial pain, so confirming the diagnosis sometimes takes years. The doctor asks about the nature of the attacks and rules out other causes, including dental ones.

When to see a neurologist

The reason for a visit is frequent or persistent facial pain, especially if conventional painkillers do not help and the dentist has ruled out dental causes. The neurologist asks about the symptoms and rules out other causes of pain, and if necessary refers for additional tests.

• attacks of shooting pain in one half of the face;
• pain triggered by touch, eating, or wind;
• painful tic of the facial muscles during an attack;
• pain that may radiate to the eye, ear, teeth, or jaw.

This condition by itself is not a reason to call an ambulance; 103 or 112 — if a stroke or another life-threatening condition is suspected.

This article is for reference and does not replace a doctor's consultation: only a specialist after an examination can say what exactly is causing your pain.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer