Trigeminal Neuralgia (Facial Pain)

What causes facial pain?

The most common cause of facial pain is trigeminal neuralgia. Pain arises from the trigeminal nerve (fifth cranial nerve) and manifests as sharp, shooting pain lasting for a few seconds to minutes. Talking, brushing teeth, eating or putting on make-up triggers the pain.

What is the treatment for trigeminal neuralgia?

An MRI scan must be carried out to exclude compression of the trigeminal nerve in the brain. A blood vessel, or rarely, tumour, can press onto the nerve and cause trigeminal neuralgia. If this happens, referral to a neurosurgeon is needed. In primary trigeminal neuralgia – where there is no cause for the pain – medications such as carbamazepine, gabapentin or pregabalin may help. Severe trigeminal neuralgia not responding to painkillers can be treated using radiofrequency ablation.

What is radiofrequency (RF) ablation?

A special RF needle is inserted into the trigeminal ganglion. RF energy is then generated through a machine to create heat. This heat is transmitted through the needle tip to destroy the painful division of the trigeminal nerve. This is a day surgery procedure that is performed using CT guidance under mild sedation. RF ablation can effectively reduce facial pain in more than 90% of patients.