Trigeminal Neuralgia, Atypical Facial Pain, Burning Mouth Syndrome

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Trigeminal Neuralgia, Atypical Facial Pain, Burning Mouth Syndrome

Trigeminal neuralgia is a nerve disorder that causes a stabbing or electric-shock-like pain in parts of the face. It can be very painful, sharp electric-like spasms that usually last a few seconds or minutes, but can become constant reducing patient to tears. Pain is usually only on one side of the face, often around the eye, cheek, and lower part of the face and may be triggered by touch or sounds or common, everyday activities, such as brushing teeth, chewing, drinking, eating, lightly touching the face or shaving.

The pain of trigeminal neuralgia comes from the trigeminal nerve. This nerve carries pain, feeling, and other sensations from the brain to the skin of the face. It can affect part or all of the face, and the surface of the eye. The condition usually affects older adults, but it may affect anyone at any age. Trigeminal neuralgia may be part of the normal aging process. Sometimes it can be caused by serious conditions such as multiple sclerosis and tumors but often no cause is found. Trigeminal neuropathy, a separate condition that has numbness or paraesthesia is more likely to be something serious and would require thorough examination. Diagnosis involve excluding dental pain which is more common than the medical conditions. An expert assessment is often needed and may involve blood tests, MRI and other investigations. Unfortunately, patients may present at the dental office and had teeth taken out unnecessarily but the pain still persists. Treatment can be complicated and our clinic provides both medical and surgical treatment for the condition.

If medical treatment fails (eg too heavy dosage of Tegretol resulting in drowsiness or allergic reactions), trigeminal neuralgia could be treated with cryotherapy to the nerve besides major neurosurgery.

Facial pain can be very difficult to diagnose and includes a wide range of disorders such as atypical facial pain, burning mouth syndrome, migrainous headaches etc . A careful history and neurological examination is required as well as dental examination to exclude dental causes. This is a special area of expertise with our surgeon Dr Fan who is qualified in both dentistry and medicine.

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Dr Victor Fan
MB BCH; BAO (UK)
BDS (Singapore)
FDSRCS (England)
FRCS (England)
FRCS (Intercollegiate)  
FAMS
FICS

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