Trigeminal Neuralgia

Trigeminal neuralgia (TN) is a chronic nerve pain condition that causes sudden, electric shock–like facial pain along one or more branches of the trigeminal nerve. At Covenant Spine and Neurology, our board-certified specialists combine advanced diagnostics with compassionate, individualized care to help reduce pain, improve function, and restore quality of life.

What Is Trigeminal Neuralgia?

The trigeminal nerve carries sensation from the face to the brain. When the nerve is compressed, irritated, or hyper-excitable, it can trigger brief episodes of severe facial pain, often on one side, brought on by everyday activities such as talking, chewing, brushing teeth, shaving, or a light breeze.

 

Common symptoms include:

 

  • Sudden, stabbing, shock-like pain on one side of the face

  • Pain episodes lasting seconds to minutes, with periods of remission or clustering

  • Trigger points around the lips, gums, cheek, jaw, or eye

  • Increased sensitivity to touch, temperature, or routine facial movement

Causes and Triggers

Trigeminal neuralgia may be due to vascular compression of the nerve near the brainstem, nerve demyelination (as in multiple sclerosis), prior facial trauma or dental procedures, or, less commonly, structural changes such as a tumor or cyst. Common triggers include talking, smiling, chewing, brushing teeth, washing the face, makeup application, shaving, or exposure to wind/cold air.

How We Diagnose TN

Accurate diagnosis is essential because several conditions can mimic TN. Your evaluation may include:

 

  • Comprehensive neurological exam and detailed symptom history

  • MRI/MRA to assess the trigeminal nerve, brainstem, and surrounding blood vessels

  • Targeted testing to rule out other causes of facial pain (e.g., dental, sinus, temporomandibular joint disorders)

Personalized Treatment Options

Treatment is tailored to your symptoms, triggers, and overall health. Plans may include one or more of the following:

 

Medication Management

 

  • First-line anticonvulsants (to stabilize nerve activity)

  • Adjunct medications (as appropriate) to reduce breakthrough pain and improve tolerance

Office-Based & Interventional Therapies

 

  • Peripheral nerve blocks or trigger point injections for diagnostic and therapeutic relief

  • Botulinum toxin injections (in appropriate cases) to reduce pain frequency/intensity

Advanced/Surgical Referrals

 

For patients who do not respond to conservative care, we coordinate with trusted neurosurgical partners for options such as microvascular decompression, stereotactic radiosurgery, or percutaneous ablative procedures—and remain involved in your continuity of care before and after intervention.

 

Supportive Care & Prevention

 

  • Flare-management strategies and trigger avoidance

  • Guidance on oral care, nutrition, sleep, and stress reduction

  • Ongoing follow-ups to fine-tune your plan and monitor progress

When to Seek Care

Contact a specialist if you experience recurring, shock-like facial pain, if your pain is worsening or disrupting daily activities, or if over-the-counter approaches are no longer helping. Early evaluation can shorten time to relief and reduce the impact on quality of life.

Why Choose Covenant Spine and Neurology

  • Board-certified neurologists with focused experience in facial pain disorders

  • Advanced imaging and diagnostics for precise treatment planning

  • Integrated, compassionate care with clear education at every step

  • Coordinated referrals for advanced procedures when needed

  • Individualized follow-up to help you stay ahead of flares and triggers

Frequently Asked Questions (FAQ)

Is trigeminal neuralgia curable?

Some patients achieve long-term relief with medication or procedures; others manage TN as a chronic condition with periodic adjustments.

 

What makes TN pain different from dental pain?

TN pain is typically sudden, electric-like, and triggered by light touch or movement; dental pain is often constant and localized to a tooth. We work with dental providers if clarification is needed.

 

Will I need surgery?

Many patients improve with medication and targeted injections. Surgery is considered when conservative treatments are insufficient.

Take the Next Step Towards Relief

Schedule a consultation with Covenant Spine and Neurology to discuss a personalized plan for trigeminal neuralgia care or click here to find one of our locations near you.

Book Your Appointment Now

For more information or to schedule an appointment call us at 336-761-4020.

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