Does trigeminal neuralgia cause facial swelling?

Written by Chen Yu Fei
Neurosurgery
Updated on January 31, 2025
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For patients with trigeminal neuralgia, when they frequently experience bouts of pain, most do not have significant facial swelling. The pain typically occurs distinctly in the areas distributed by the trigeminal nerve roots, often starting and stopping suddenly, and each episode may last from a few seconds to several minutes. Due to repeated pain, facial muscle atrophy may occur, but generally, there is no swelling of the face. For treating trigeminal neuralgia, surgery is commonly used. Microvascular decompression surgery is often recommended to help improve symptoms and can even achieve a clinical cure.

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Written by Gao Yi Shen
Neurosurgery
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Trigeminal neuralgia symptoms

Regarding the symptoms of trigeminal neuralgia, there is a very typical symptom, which is the issue of trigger points. A trigger point is a specific spot on the face, which varies for each person. Once this spot is touched, it immediately triggers the pain of trigeminal neuralgia. The nature of trigeminal neuralgia pain is often like cutting or stabbing pain, and the duration varies. If the condition is mild, the initial attack may only last a few seconds, but if the condition gradually worsens without significant improvement, the pain can even last for several minutes. This pain significantly impacts patients, sometimes triggering pain during activities such as brushing teeth, rinsing the mouth, or chewing hard food. Early treatment is essential to mitigate this pain.

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trigeminal neuralgia scope

The range of trigeminal neuralgia attacks is usually located in the sensory area of the trigeminal nerve root, broadly covering both sides of the patient's nostrils and around the corners of the mouth. The nature of the pain is quite severe, often described as knife-like pain or burning pain. The duration of each pain episode varies, often starting and stopping suddenly. Around the pain area, fixed trigger points are likely to form. Accidentally touching these trigger points while brushing teeth, washing faces, or rinsing mouths can often trigger an attack of trigeminal neuralgia. Over time, due to repeatedly triggering the pain by touching these points, patients may become afraid to wash their faces or brush their teeth, and may experience facial muscle numbness or atrophy.

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Early manifestations of trigeminal neuralgia

For patients with trigeminal neuralgia, the initial symptoms mainly include sudden onset of intense pain that stops abruptly. The nature of the pain is generally sharp, resembling sharp stabbing or knife-like pain. In most cases, trigger points are easily formed on the face, commonly appearing around the bilateral nostrils and corners of the mouth as fixed trigger points. Touching these trigger points can easily trigger an attack of trigeminal neuralgia, which lasts for a relatively short duration, typically from a few seconds to several seconds. In most cases, attacks are more likely to be triggered when the patient is tired, fatigued, or under mental stress.

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Causes of Trigeminal Neuralgia

At present, there is no consensus on the specific causes of trigeminal neuralgia. Most scholars believe that the main cause of trigeminal neuralgia is still due to the presence of a local responsible blood vessel around the trigeminal nerve, which compresses the trigeminal nerve, leading to abnormal discharges of the trigeminal nerve. This results in sudden attacks and sudden stops of severe, knife-like or burning pain, also known as trigeminal neuralgia. In terms of treatment, it mainly involves active drug therapy and some physical therapies, such as massage, manipulation, physiotherapy, and acupuncture. Most patients who experience poor results from conservative treatments can opt for microvascular decompression surgery, which often achieves good therapeutic outcomes.

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Does trigeminal neuralgia require craniotomy?

If the severity of trigeminal neuralgia is mild, oral medication can be chosen as the first treatment option. If the effects of the medication are not significant, radiofrequency treatment for the trigeminal nerve or balloon compression therapy can be considered, although these two methods do have a certain recurrence rate. If the effects of medications and treatments like radiofrequency are not significant, microvascular decompression surgery for the trigeminal nerve can be considered. This surgery requires general anesthesia and craniotomy, and under a microscope, the trigeminal nerve and the blood vessels compressing it are separated using a special material, which can relieve the pain of trigeminal neuralgia.