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An Introduction to Trigeminal Neuralgia

What is TN?

The trigeminal nerve is the fifth cranial nerve and its function is to send pain messages to the brain.  When the nerve malfunctions, pain messages are sent at inappropriate times and the pains can be of great severity.  In fact, TN is regarded as the most painful condition that is known in the medical world.

The pains are variously described as like a strong electric shock shooting through the face, or very intense sensations of stabbing and burning.  TN affects more women than men and pains are normally felt on one side of the face only, generally the right-hand side. The majority of people affected are over 50 years old although young adults, and very rarely children, may also develop the condition.

As can be seen in the diagram below, the trigeminal nerve has three branches (or divisions) on each side of the face:

TN ann eAstman

Illustration by TNA UK member, Ann Eastman

  • the Opthalmic branch which runs above the eye, forehead and front of the head
  • the Maxillary branch which runs through the cheek, upper jaw, teeth and gums, and to the side of the nose
  • the Mandibular branch which runs through the lower jaw, teeth and gums.

TN pains can result from one or more branches but the middle and lower branches are most frequently affected.

What are the Causes of Trigeminal Neuralgia?

More research still needs to be undertaken into TN but the transmission of abnormal messages of pain often appears to result from damage to the protective coating (myelin sheath) around the trigeminal nerve.  There are several possible causes of damage, including pressure from blood vessels or arteries, and, very rarely, tumours or multiple sclerosis.


There is no diagnostic test for TN, so the patient’s description of the pattern and nature of the pains is vitally important when it comes to getting an accurate diagnosis.  An MRI scan may show a compression of the trigeminal nerve by a blood vessel but even if no compression is visible, the cause of the pain may still be TN.


Anti-convulsant medications are normally prescribed for people with TN and there are also a number of surgeries available which offer relief.  However, unless the diagnosis is classic TN, surgical procedures may make the pain far worse.  For this reason, it is important to research the condition thoroughly with the help of an informed specialist before making any decisions on treatment.

For more detailed information, please read our booklet Trigeminal Neuralgia – An Overview which is reproduced in part below or click on the following link to download a printable version if you would rather read this later at your leisure:  Downloadable booklet: Trigeminal Neuralgia - An Overview

Further Information Available

Two excellent books are available from TNA UK:

Striking Back—the layman’s guide to understanding and treating what is often called the world’s worst pain.

The authors are George Weigel, an American journalist and TN patient and Dr Kenneth Casey, a neurosurgeon who has worked closely over many years with Dr Peter Jannetta, the ‘Godfather’ of the microvascular decompression (MVD) procedure.  This book gives full details about trigeminal neuralgia and other types of facial pain in a way that is understandable to medics and non-medics alike.  For anyone suffering from TN, this is compulsive reading.  Armed with the detailed information in this book, individuals are helped to make more knowledgeable choices about their care and treatment.

Insights—Facts and stories behind trigeminal neuralgia

Written by Professor Joanna Zakrzewska, one of the world’s recognised authorities on TN and Medical Advisor to TNA UK.  The publication details patients’ experiences and scientific data, and provides an illustrated roadmap from diagnosis to the best available medical and surgical treatments, as well as practical tips on coping with recurrent pain.  The focus is very much on the person with TN and the book includes guidelines for creating more effective patient care.  It is a useful reference for sufferers, their families and carers, as well as for healthcare professionals seeking to help their patients.

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Page last updated on 19 Jan 2017