Trigeminal Neuralgia: The Lesser-Known Condition That Could Be Behind Your Head Pain

When your head hurts, you'll typically consider the usual suspects — migraines or tension headaches. While these are some of the most common causes of head pain, an often overlooked cause is a condition called trigeminal neuralgia (TN). 

TN is frequently misunderstood and misdiagnosed, leading to delays in proper treatment and care. Many people live with years of pain, often going through unnecessary dental procedures or trying various headache treatments, before receiving an accurate diagnosis of TN. 

In Tampa, Florida, Dr. Phillip Henkin and our team at the NeuroSpine Center specialize in diagnosing and treating this pesky condition. This blog explains how to recognize TN and what you can do about it. 

What is trigeminal neuralgia

TN, also known as "tic douloureux," is a neurological condition that affects the trigeminal nerve, one of the most extensive nerves in your head. This nerve sends sensations from your face to your brain, which can cause intense facial pain when affected.

Everyday activities such as eating, speaking, or even a gentle breeze can trigger a painful flare-up. People with this condition often describe the pain as often as a sharp shooting or electric shock-like sensation, primarily affecting one side of their face.

Identifying trigeminal neuralgia

The telltale sign of TN is extreme, sporadic, and sudden burning or shock-like facial pain. These episodes can last from a few seconds to several minutes and often occur in rapid succession. 

You typically feel the pain on one side of the face, and the slightest touch can trigger it. The frequency and intensity of these attacks can vary significantly from person to person.

Causes and risk factors

The primary cause of TN is trigeminal nerve compression, usually at the nerve root near your brainstem, where a blood vessel presses against and irritates the nerve, leading to severe pain.

Beyond nerve compression, TN can also develop due to other reasons. For example, neurological disorders like multiple sclerosis can affect the nerve’s protective covering, increasing the risk of TN. 

In rare cases, a tumor pressing against the trigeminal nerve or physical impacts from sinus surgery, facial trauma, or stroke can lead to TN.

Certain people are also more susceptible to developing TN. It tends to be more prevalent in people over 50, and women are more frequently diagnosed with the condition.

Diagnosing trigeminal neuralgia

At the NeuroSpine Center, Dr. Henkin diagnoses TN by first investigating your symptoms. TN is marked by sudden, severe facial pain, often triggered by everyday activities. 

To confirm a diagnosis of TN and rule out other conditions, we use advanced imaging techniques like magnetic resonance imaging (MRI). MRI helps us see the trigeminal nerve and identify if a blood vessel is compressing it. 

Sometimes, we recommend additional tests like reflex testing to assess the trigeminal nerve’s response.

Treatment options 

Once we confirm TN is behind your head pain, we create a treatment plan tailored to your needs, which typically includes:

Medication

The first line of treatment generally involves medications. We commonly prescribe anticonvulsants to manage pain, which can help stabilize nerve function. In some cases, we also recommend muscle relaxants.

Surgery

For people who do not respond to medication, we consider surgery. Microvascular decompression (MVD) is a procedure where we remove or relocate any blood vessels compressing the trigeminal nerve. 

Gamma knife radiosurgery is a less invasive option and uses focused radiation to target and damage the area of the nerve root that causes pain.

Managing TN goes beyond medical treatment. It involves understanding your triggers, adopting lifestyle changes, and getting the proper support to help you through the emotional impact of living with chronic pain. 

At the NeuroSpine Center, we’re committed to providing you with the highest level of care for TN. Dr. Henkin guides you through the diagnosis, treatment, and management of TN. Schedule a consultation with him online today or call 813-534-4945.