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Trigeminal Neuralgia

Apex Spine and Neurosurgery

Neurosurgery & Minimally Invasive Spine Surgery located in Roswell & Bethlehem, GA

Trigeminal neuralgia causes excruciating pain on one side of your face, pain that appears in attacks that can occur many times every day before you go into a temporary remission. The board-certified neurosurgeons at Apex Spine and Neurosurgery have extensive experience effectively treating trigeminal neuralgia using a surgical procedure called microvascular decompression. Don’t keep suffering from the severe pain of trigeminal neuralgia. Call one of the offices in Roswell, Alpharetta, or Bethlehem, Georgia, or schedule an appointment online today.

Trigeminal Neuralgia Q & A

What causes trigeminal neuralgia?

Trigeminal neuralgia occurs when the trigeminal nerve is compressed. You have a trigeminal nerve on both sides of your face, where both nerves divide into three branches that control sensations in your:

  • Forehead
  • Eyes
  • Eyelids
  • Cheeks
  • Nostrils
  • Lips
  • Gums
  • Jaw
  • Muscles used for chewing


Trigeminal neuralgia usually occurs when the nerve is compressed by an artery at the base of your brain. However, the condition can also develop if a tumor pinches the nerve. It’s also a common problem in people with multiple sclerosis. 

What symptoms develop if I have trigeminal neuralgia?

Trigeminal neuralgia causes excruciating, electric-shock pain that travels along the nerve, affecting one side of your face. When the condition first develops, the pain is usually along the upper or lower jaw, leading many patients to believe they have a dental problem. 

Once the pain attacks begin, your pain is classified as Type I or Type II.

Type I pain

This is the classic type of severe, intensely sharp, throbbing, shock-like pain. Pain attacks may occur once a day or you could have a dozen or more every hour.

Each attack begins with an electric shock that quickly turns into excruciating pain. The pain often leads to uncontrollable facial muscle twitching, which is why the condition is also called tic douloureux.

Most patients suffer frequent pain attacks for a time before entering remission. Once the attacks return, however, they usually get more frequent and intense, and you will have shorter remission periods. 

Type II pain

Type II pain, called atypical pain, is a constant, burning type of pain over a widespread area of your face. This type may not go into remission. 

What triggers a trigeminal neuralgia attack?

The pain attacks are triggered by activities such as:

  • Talking
  • Smiling
  • Washing
  • Shaving
  • Brushing your teeth
  • Blowing your nose
  • Touching your face
  • Exposure to a light breeze


Even drinking a hot or cold beverage can trigger the pain. 

What is hemifacial spasm?

Hemifacial spasm occurs when another cranial nerve called the facial nerve is compressed by a blood vessel. This condition causes frequent, uncontrollable muscle spasms on one side of your face.

The earliest symptom is typically eyelid twitching, then the spasms spread to muscles in your lower face, causing twitching that pulls your mouth to one side. Eventually, the spasms involve all the muscles on one side of your face. 

How is trigeminal neuralgia treated?

Medications may control a mild case of trigeminal neuralgia and hemifacial spasm. However, you need surgery to stop both problems. 

One surgical procedure is called microvascular decompression. This procedure involves exposing the nerve, identifying the blood vessel that’s compressing the nerve, and then gently moving the blood vessel out of the way. This procedure decompresses the nerve, allowing it to recover and alleviating your trigeminal neuralgia. 

Some patients may be good candidates for a lesioning procedure. This surgical procedure uses different techniques such as heat to create a wound on the nerve. The wound stops pain signals from reaching your brain, which decreases your pain.

If you need experienced treatment for trigeminal neuralgia, call Apex Spine and Neurosurgery, or book an appointment online.

Fax Number for both locations: (678) 963-5307