Symptoms - Trigeminal neuralgia

The main symptom of trigeminal neuralgia is sudden attacks of severe, sharp, shooting facial pain that last from a few seconds to about 2 minutes.

The pain is often described as excruciating, like an electric shock. The attacks can be so severe that you're unable to do anything while they're happening.

Trigeminal neuralgia usually affects one side of the face. In some cases it can affect both sides, although not usually at the same time.

The pain can be in the teeth, lower jaw, upper jaw or cheek. Less commonly the pain can also be in the forehead or eye.

After the most severe pain has subsided you may experience a slight ache or burning feeling. You may also have a constant throbbing, aching or burning sensation between attacks.

You may experience regular episodes of pain for days, weeks or months at a time. Sometimes the pain may disappear completely and not return for several months or years. This is known as remission.

In severe cases of trigeminal neuralgia the attacks may happen hundreds of times a day and there may be no periods of remission.

Symptom triggers

Attacks of trigeminal neuralgia can be triggered by certain actions or movements, such as:

• talking
• smiling
• chewing
• brushing your teeth
• washing your face
• a light touch
• shaving or putting on make-up
• swallowing
• kissing
• a cool breeze or air conditioning
• head movements
• vibrations, such as walking or travelling in a car

However, pain can happen spontaneously with no trigger whatsoever.

Further problems

Living with trigeminal neuralgia can be very difficult and your quality of life can be significantly affected.

You may feel like avoiding activities such as washing, shaving or eating so you do not trigger the pain, and the fear of pain may mean you avoid social activities.

However, it's important to try to live a normal life and be aware that becoming undernourished or dehydrated can make the pain worse.

The emotional strain of living with repeated episodes of pain can lead to psychological problems, such as depression. During periods of extreme pain some people may even consider suicide. Even when pain-free, you may live in fear of the pain returning.

Read more advice about ways to manage chronic pain.

When to see a GP

You should see a GP if you experience frequent or persistent facial pain, particularly if standard painkillers such as paracetamol and ibuprofen do not help and a dentist has ruled out any dental causes.

Trigeminal neuralgia can be difficult to diagnose. The GP will try to identify the problem by asking about your symptoms and ruling out other conditions that could be responsible for your pain.

Read more about diagnosing trigeminal neuralgia.