Trigeminal neuralgia is the most common cause of facial pain. It is a neuropathic pain condition involving the fifth cranial nerve.

Symptoms of trigeminal neuralgia include short episodes of sharp, stabbing, electrical shock-like pain involving the cheek or jaw. Pain is restricted to one side of the face in more than 90% of cases. This pain can last from seconds to minutes and it is frequently triggered by routine activities such as eating, drinking, brushing the teeth, or applying make-up.

Trigeminal neuralgia may be caused by compression of the trigeminal nerve by a blood vessel at the base of the brain. Tumour and multiple sclerosis are other important causes. A magnetic resonance imaging (MRI) of the brain may show these abnormalities. However, in many patients suffering from trigeminal neuralgia, the cause is unknown and pain control remains the mainstay of treatment.

Trigeminal neuralgia secondary to blood vessel compression of the trigeminal nerve can be treated successfully with a neurosurgical procedure called microvascular decompression.

Trigeminal neuralgia may also respond to medications such as carbamazepine, gabapentin, pregabalin or other medications for nerve pain. Interventional procedures such as Gasserian ganglion block or radiofrequency thermoablation may be performed for patients who do not respond to medical management.