Treatment for Facial Nerve Pain (Trigerminal Neuralgia)- Non Surgical

Your doctor will diagnose trigeminal neuralgia mainly based on your description of the pain, including:

• Type. Pain related to trigeminal neuralgia is sudden, shock-like and brief.
• Location. The parts of your face that are affected by pain will tell your doctor if the trigeminal nerve is involved.
• Triggers. Trigeminal neuralgia-related pain usually is brought on by light stimulation of your cheeks, such as from eating, talking or even encountering a cool breeze.

Your doctor may conduct many tests to diagnose trigeminal neuralgia and determine underlying causes for your condition, including:

• A neurological examination. Touching and examining parts of your face can help your doctor determine exactly where the pain is occurring and — if you appear to have trigeminal neuralgia — which branches of the trigeminal nerve may be affected. Reflex tests also can help your doctor determine if your symptoms are caused by a compressed nerve or another condition.
• Magnetic resonance imaging (MRI). Your doctor may order an MRI scan of your head to determine if multiple sclerosis or a tumor is causing trigeminal neuralgia. In some cases, your doctor may inject a dye into a blood vessel to view the arteries and veins and highlight blood flow (magnetic resonance angiogram).

Your facial pain may be caused by many different conditions, so an accurate diagnosis is important. Your doctor may order additional tests to rule out other conditions.

Treatment

Trigeminal neuralgia treatment usually starts with medications, and some people don't need any additional treatment. However, over time, some people with the condition may stop responding to medications, or they may experience unpleasant side effects. For those people, injections or surgery provide other trigeminal neuralgia treatment options.

If your condition is due to another cause, such as multiple sclerosis, your doctor will treat the underlying condition.

Medications

To treat trigeminal neuralgia, your doctor usually will prescribe medications to lessen or block the pain signals sent to your brain.

• Anticonvulsants -Doctors usually prescribe carbamazepine for trigeminal neuralgia, and it's been shown to be effective in treating the condition.
• Antispasmodic agents- Muscle-relaxing agents may be used alone or in combination with carbamazepine.
• Botox injections- Small studies have shown that onabotulinumtoxinA (Botox) injections may reduce pain from trigeminal neuralgia in people who are no longer helped by medications.