Trigeminal Neuralgia And Facial Numbness: Understanding The Causes And Symptoms

Trigeminal neuralgia is a painful condition that affects the trigeminal nerve, which is responsible for transmitting sensations from the face to the brain. The condition is generally categorized into two types: primary and secondary. Primary trigeminal neuralgia is often caused by blood vessels pressing on the nerve near the brainstem, while secondary cases may result from underlying conditions such as multiple sclerosis or tumors that damage the nerve's protective myelin sheath.

Why Does Trigeminal Neuralgia Affect One Side Of The Face?

In most cases, trigeminal neuralgia affects only one side of the face. This is because the condition typically involves irritation or compression of a single trigeminal nerve. The nerve has three branches — the ophthalmic, maxillary, and mandibular divisions — and pain usually occurs in one or more of these branches. When a blood vessel compresses the nerve root near the brainstem, it can cause intense, shock-like pain in the areas of the face controlled by that specific branch.

Common Symptoms Of Trigeminal Neuralgia

Patients often describe the pain as sharp, stabbing, or electric-like, similar to being cut by a knife or burned by fire. Even mild facial stimulation, such as brushing teeth, chewing, or exposure to a cool breeze, can trigger severe pain episodes. In addition to pain, some individuals may experience numbness or tingling on one side of the face, especially around the jawline. This numbness is commonly associated with involvement of the second (maxillary) and third (mandibular) branches of the trigeminal nerve, which are frequently affected in clinical cases.

Can Herpes Cause Trigeminal Neuralgia?

In some instances, trigeminal neuralgia may be linked to viral infections such as herpes zoster. When the virus affects the ear or facial regions, it can cause inflammation and damage to the trigeminal nerve, resulting in unilateral facial pain. This type of neuralgia is often accompanied by a rash or blisters in the affected area, particularly inside the ear or along the path of the nerve.

How Rare Is Bilateral Trigeminal Neuralgia?

While most cases are unilateral, bilateral trigeminal neuralgia — affecting both sides of the face — is extremely rare, occurring in only about one in several thousand patients. This makes it a less common variant of the disorder and often warrants further investigation to rule out underlying neurological conditions such as tumors or demyelinating diseases.