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What Triggers Trigeminal Neuralgia & Is It The Most Painful Condition?

Trigeminal neuralgia is the condition commonly caused due to nerve compression. There are various triggers that can initiate the condition and cause an attack, and may worsen the symptoms during an attack. The intensity of pain in trigeminal neuralgia varies from patient to patient.

What Triggers Trigeminal Neuralgia?

What Triggers Trigeminal Neuralgia?

There are various causes for trigeminal neuralgia. But the symptoms can be initiated or worsened by various triggers such as:

  • Brushing teeth
  • Applying makeup on the face
  • Shaving
  • Drinking cold drinks
  • Eating
  • Washing face
  • Touching facial skin
  • Talking
  • Moving forehead

Is It The Most Painful Condition?

Trigeminal neuralgia is a chronic and progressive painful condition. The intensity of pain varies but because of its excruciating pain, it is considered as one of the most debilitating painful condition. The pain attack causes once in a day, in weeks or in months. It can be divided as type I (also called classic) and type II (called as atypical).

Type I: In type I the pain is for a definite period of time and intensely sharp, throbbing and feel like an electric shock. The root cause of this type of pain is activated by a simple touch of any area of skin.

Type II: In type II (atypical) the duration/magnitude of pain is constant and has no subsidence. In this type of pain, patients feel burning, aching or cramping on one side of the face before pain attack.

Treatment Of Trigeminal Neuralgia

Various medications are administered for managing the symptoms of trigeminal neuralgia:

Carbamazepine: It is a type of anticonvulsant drug. These drugs block the voltage-dependent sodium channel and block the action of neurotransmitters. Carbamazepine also controls the pain that causes by the attack. But with the time that drugs decrease their effect on the disease. Carbamazepine may cause some side effects including dizziness, confusion, retinopathy, nausea, suicidal throats1.

Phenytoin: Phenytoin is generally used as first-line therapy in the treatment of trigeminal neuralgia.

Muscles Relaxant Drugs: Baclofen, muscle relaxant drug, is used in combination with carbamazepine and phenytoin1.

Botox Injection: In some case botox injection is prescribed3. It may reduce the pain of trigeminal neuralgia.

Miscellaneous Drugs: Oxcarbazepine is a newer drug which has a similar structure to carbamazepine .it is used as a first line drug because of fewer side effects2.

Surgery is considered as the option to permanently cure this condition. Surgery used for treating trigeminal neuralgia includes rhizotomy and microvascular decompression. Rhizotomy is of various types such as Glycerol injection rhizotomy, Balloon compression rhizotomy, and Radiofrequency thermal lesioning rhizotomy.

Trigeminal neuralgia is also known as tic douloureaux1. It is one of the most painful conditions in human. Basically, it is a nerve disorder in which the affected part is trigeminal nerve (fifth of 12 pairs of cranial nerves in the head) due to nerve irritation or damage. This is mainly caused on the one side of the face but in the rare chance, it affects both sides of the face. Approximately 14000 people affected in United states1. It is common in men and women. The affected areas are the forehead, cheek, nose, teeth, gum lip, and rarely in eyes, etc.

Cause Of Trigeminal Neuralgia

In trigeminal neuralgia, the function of the nerve is disturbed. The main cause of this disorder is the pressure on the nerve or irritation due to contact between the blood vessels and trigeminal nerve.

  • It may also be due to hard brushing and applying makeup on the face.
  • Surgical & dental injury, trauma also causes trigeminal neuralgia’
  • Tumor or cyst may also lead to this condition.
  • Multiple sclerosis damages the Muslim sheath of nerves. This results in increased sensitivity of trigeminal nerve against the compression of blood vessels.

In some patients, trigeminal neuralgia is caused by arteriovenous malformations.


Triggers that can initiate or worsen trigeminal neuralgia includes eating, washing face, drinking cold liquids, speaking, and brushing. The intensity of pain increases as the disease progresses.


Also Read:

Sheetal DeCaria, M.D.
Sheetal DeCaria, M.D.
Written, Edited or Reviewed By: Sheetal DeCaria, M.D. This article does not provide medical advice. See disclaimer
Last Modified On:July 9, 2019

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