What is facial pain?

Facial pain is a common condition that can have a number of causes including:

• Headaches and migraines
• Injury to the face
• Nerve damage
• Jaw and dental problems
• Infections
• Tumours

There are some facial nerve conditions such as trigeminal neuralgia that can cause facial pain. 

What is trigeminal neuralgia?

Trigeminal neuralgia is a long term nerve condition that affects around one in one thousand people. 

Symptoms include: 

• Short bursts of pain that affect areas of the face, teeth and inside the mouth, usually on one side
• Mild to severe pain that can be stabbing, intense or shooting
• Pain that can last seconds or several minutes
• Pain that can come up quite often
• Triggers can include lightly touching the face, cold wind or cold water
• Pain that tends to get worse over time, although some people can be without pain for months or years

What causes trigeminal neuralgia?

Compression of the trigeminal nerve causes trigeminal neuralgia. The trigeminal nerve is one of the nerves in your face that transmits information from your jaw, mouth and teeth to your brain. 

When it gets squeezed (compressed) it can cause sharp, electrical type shooting pains in your face and mouth. Even a light touch to the skin or a cold gust of wind can trigger pain.

In 95% of cases trigeminal neuralgia has a primary cause, for example, when there is an artery or vein squashing the trigeminal nerve. 

In the remaining 5% of cases, there’s a secondary cause of trigeminal neuralgia which can be due to: 

• Multiple sclerosis (MS)
• Tumour on the nerve
• Cyst or benign growth on the nerve
• Abnormal tangle of arteries
• Damage caused by surgery

How is trigeminal neuralgia diagnosed?

During your visit to The London Clinic your specialist will take your full medical history and ask you about your symptom pattern. 

Your neurologist can make a diagnosis of trigeminal neuralgia in several ways:

• By looking at your symptoms and characteristics of the pain, including whether you have ‘electrical’ shocks in the face
• Assessing which stimuli trigger an attack, e.g. brushing teeth, eating, or cold weather
• Assessing whether you have a coexisting neurological condition e.g MS
• Assessing whether certain medication alleviates the pain

They may send you for an MRI scan to further investigate any underlying causes and whether it’s from a migraine, cyst or post-viral neuralgia. 

How is trigeminal neuralgia treated at The London Clinic? 

Many people manage the pain from trigeminal neuralgia with certain medications. However, medication isn’t effective for everyone.

At The London Clinic we may offer you a number of non-invasive treatments including: 

Glycerol injections 

Your specialist injects glycerol around the Gasserian ganglion at the nerve root.

Gamma Knife or radiofrequency lesioning

Your specialist applies heat to the Gasserian ganglion through a needle.

Balloon compression 

Your specialist passes a tiny balloon near the Gasserian ganglion and inflates it.

CyberKnife radiation treatment 

Your specialist delivers radiation to the Gasserian ganglion. CyberKnife is an excellent non-invasive alternative to surgery as it carries much less risk. CyberKnife has an 80-90% success rate of treating trigeminal neuralgia symptoms. However, you may need to repeat the treatment after three to ten years.

For some people microvascular decompression, to separate the trigeminal nerve root from a potentially irritating artery, can offer effective pain relief. One of our neurosurgeons does this through an open craniotomy procedure. 

At The London Clinic our specialists are world leaders in their field. While you’re with us you’ll receive excellent care from pre-assessment right through to any treatment and aftercare.