Trigeminal Nerve Inflammation: What It Is, Causes, and Symptoms

Pain in one half of the face, described as an electric shock or a jolt in the jaw, is a common reason to see a doctor. It may be caused by the trigeminal nerve: its compression, irritation, or damage. Below: how it is structured, what causes its inflammation and compression, and whom to consult with such a complaint.

What the trigeminal nerve is and what it is responsible for

The trigeminal nerve is one of the largest nerves of the head: its fibers carry sensations of pain and touch from the skin of the face, teeth, gums, and oral cavity to the brain. It has three branches serving the upper, middle, and lower zones of the face. In trigeminal neuralgia, the second and third branches are affected more often, while the first is involved in about 5% of cases.

Inflammation and neuritis of the trigeminal nerve: what they are

In everyday speech people say "inflammation of the trigeminal nerve"; in the medical literature it is neuralgia: a chronic disease with attacks of intense, shooting, and burning pain in the areas innervated by the nerve. The mechanism is usually as follows: the root at the point where it exits the pons of the brain is compressed and undergoes demyelination, losing its myelin sheath. There are two forms: primary, idiopathic, and secondary, symptomatic — against the background of another disease. The French synonym tic douloureux, "painful tic," is still found in reference books: during an attack, the muscles on the affected side of the face contract involuntarily.

Causes: what makes the nerve become inflamed and compressed

Compression of the root by a tortuous, altered vessel explains up to 80–90% of cases. Less often the nerve is damaged by a tumor, in multiple sclerosis a plaque forms in the area of the sensory nucleus, and there may be consequences of jaw injuries. Some cases remain without an established cause. Prevalence is estimated at approximately 1 case per 15,000 people; the figure may be underestimated due to diagnostic errors. Women are affected more often, the disease usually begins at 50–60 years of age and is rare before 40.

How pain manifests in trigeminal nerve damage

An attack lasts from a few seconds to about two minutes and stops as suddenly as it began. The pain is more often unilateral and is felt in the lower part of the face — in the jaw, teeth, gums; extremely rarely both halves are affected, and almost never simultaneously. Episodes come in series — lasting days, weeks, months, and in severe cases occurring hundreds of times a day. Remissions lasting months and years are possible, but over time they become shorter, and constant aching or burning pain is added to the sharp jolts. Attacks are triggered by washing, eating, brushing teeth, shaving, talking, wind, and the airflow from an air conditioner.

• short jolts of pain in one half of the face;
• trigger zones in the area of the nasolabial triangle;
• pain-free intervals between attacks.

How diseases of the trigeminal nerve are diagnosed

There is no specific test that confirms neuralgia: the diagnosis is made based on the description of the attacks. The doctor asks about the nature of the pain, its localization, and triggers. Confirming the diagnosis may take several years. The doctor may order additional examinations to rule out other causes of facial pain. If conventional painkillers do not help, this is a reason to see a doctor.

When to see a neurologist

The reason for a consultation is frequent or persistent pain in the facial area, especially if painkillers do not help and the dentist has not found a dental cause. It is better for a neurologist to investigate such a complaint: they will ask about the symptoms and decide which examinations are needed. With prolonged pain syndrome, a person loses weight, becomes withdrawn, and develops depression, and this should also be mentioned at the appointment.

Facial pain by itself is not a reason to call an ambulance; 103 or 112 — for a life-threatening condition, for example if a stroke is suspected.

This material is for reference: it explains the mechanism and provides guidance on symptoms, but does not replace a doctor's consultation — only a specialist at an appointment can determine the causes and choose a management strategy.

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