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Trigeminal Neuralgia and MS

By Matt Cavallo

Many people living with MS suffer from chronic pain. Estimates that more than half of the people living with MS have chronic pain as a result of their condition. One of the most extreme forms of pain that a person with MS can experience is trigeminal neuralgia.

Trigeminal neuralgia is a type of chronic pain that affects the trigeminal nerve. The trigeminal nerve carries sensations from your face to your brain. There are two trigeminal nerves, one on the right and one on the left side of your face. They split into three branches: the upper reaches up to the scalp and the forehead, the middle reaches nose and the cheek and upper jaw, and the lower reaches the lower jaw and mouth. 

Trigeminal neuralgia occurs in MS when the myelin sheath has been damaged and the nerve becomes irritable. Trigeminal neuralgia pain is unpredictable and can be caused by the activities of daily living. Things like eating, drinking, brushing your teeth, shaving, or putting on makeup can be a source of trigeminal neuralgia pain. Moving your head, talking, hot or cold sensations, and wind can also spark the searing intense pain of trigeminal neuralgia. The most frustrating thing about trigeminal pain is that there doesn’t have to be a trigger at all. It can just happen – anywhere and at any time. 

Trigeminal neuralgia pain timing differs from person to person. For some, the pain lasts a couple of seconds. For others, it can last a couple of minutes. For others, the pain is constant. Most report the pain to have either an electric shock quality or be a burning, searing type of pain. Trigeminal pain usually comes in waves and then goes into remission.

People living with trigeminal neuralgia may suffer from lack of sleep or depression because of the pain. People may also have problems eating and with other activities of daily living because of trigeminal neuralgia pain. If trigeminal neuralgia pain is affecting your quality of life, there are medical professionals who can help. Let your neurologist know about how the pain is affecting your life and the neurologist can send you to a mental health professional like a psychologist to talk about the lack of sleep or depression. You may also be referred to an occupational therapist to help with some of the activities of daily living, such as eating.

Trigeminal neuralgia pain typically occurs in your fifties. However, the American Association of Neurological Surgeons said MS is the number one cause of trigeminal pain in young adults. Trigeminal neuralgia is also more common in women than in men. 

Trigeminal neuralgia is different from dental pain and is treated very differently. If you are having facial pain, you will want to contact your neurologist right away. Your neurologist can prescribe medicine like, carbamazepine or baclofen, to help control the trigeminal neuralgia pain. If the medicine is ineffective, then surgery may be a necessary option.  Although there is no cure for trigeminal neuralgia, finding the right specialist and treatment option can help you cope with the pain and effectively manage your symptoms.