Who Is More Likely to Develop Trigeminal Neuralgia?

Trigeminal neuralgia, often referred to as "the most excruciating pain known to man," is characterized by sudden, severe facial pain that occurs in the areas supplied by the trigeminal nerve. This pain is typically paroxysmal, meaning it starts and stops abruptly, and is often described as electric shock-like, stabbing, or cutting. It tends to occur more frequently during the daytime. Each episode can last from a few seconds to up to two minutes, causing unbearable discomfort during attacks. Between episodes, patients usually experience no symptoms. However, as the condition progresses, pain attacks become more frequent and the intervals between them shorten. Certain groups of people are more prone to developing this condition.

1. Individuals with Hypertension, High Cholesterol, or Atherosclerosis

Age is a major factor in the development of trigeminal neuralgia. As people grow older, the curvature of blood vessels increases and their elasticity decreases. Conditions such as hypertension, high cholesterol, and atherosclerosis can accelerate this natural aging process. Clinically, it has been observed that atherosclerotic blood vessels or vascular loops around the trigeminal nerve may calcify over time, which is often a contributing factor to the onset of this painful disorder.

2. People with Temporomandibular Joint (TMJ) or Occlusal Dysfunction

Issues such as premature tooth contact, severe malocclusion, missing molars, or excessive tooth wear can lead to dysfunction of the jaw system. These problems may cause muscle spasms around the temporomandibular joint, which in turn can trigger trigeminal neuralgia. The close anatomical relationship between the jaw muscles and the trigeminal nerve makes this a significant risk factor for some individuals.

3. Patients with Sinusitis or Dental Infections

Inflammatory conditions affecting the face, nasal passages, and oral cavity—such as sinusitis or dental infections—can create chronic inflammatory foci. These persistent sources of irritation may disrupt the normal function of the trigeminal nerve, leading to neuralgic pain. Prompt treatment of such infections is crucial to prevent long-term nerve complications.

4. Those Who Have Had Viral Infections

Herpes Zoster and Herpes Simplex Virus Infections

Viral infections like herpes zoster (shingles) and herpes simplex virus (HSV) can lead to painful skin rashes and blisters on the face. These viruses can travel along the trigeminal nerve pathways into the skull and remain dormant in the trigeminal ganglion. In some cases, this latent presence can trigger episodes of trigeminal neuralgia, especially during periods of immune system weakness.