Overview

Trigeminal neuralgia (TN) is a pain disorder of the trigeminal nerve. Trigeminal neuralgia is also known a as tic douloureux. The trigeminal nerve – also called the 5th cranial nerve – supplies feeling and sensation to the face, mouth, and the front half of the scalp. It also controls the muscles involved in chewing. The trigeminal nerve has three major branches (Figure 1):

• Ophthalmic nerve – provides sensation to the eye, forehead, and the front portion of the nose (see the area shaded blue).

• Maxillary nerve – provides sensation to the side of the nose, lower eyelid, cheek, and the upper jaw, teeth, gums, and lip (see the area shaded yellow).

• Mandibular nerve – provides sensation to the lower jaw, teeth, gums, and lip. This branch also controls the muscles involved in chewing (see the area shaded red).

The three branches of the trigeminal nerve carry sensations of touch, pain, temperature, and movement from the face and mouth, and come together at the base of the skull bone in an area called the trigeminal or Gasserian ganglion. From there, the main trigeminal nerve root enters the brain in an area of the brainstem called the pons.

What are the Risk Factors for Trigeminal Neuralgia?

Trigeminal neuralgia is one of the most painful disorders known. Even though TN has been classified as a rare disease by the National Organization of Rare Diseases (NORD), it is probably the most common cause of severe facial pain.

The number of people who develop TN increases with age. The disorder most frequently occurs in people between 50 and 70 years of age, but it can occur in younger individuals. It rarely occurs in children, although it does happen. Women develop TN nearly twice as often as men. It is somewhat more common on the right side of the face. It most often affects the side of the nose, lower eyelid, cheek, and the upper jaw, teeth, gums, and lip (the maxillary part of the nerve) and/or the lower jaw, teeth, gums, and lip (the mandibular part of the nerve).