What Is Trigeminal Neuralgia?

Trigeminal neuralgia is a nervous system disorder that causes sudden, severe and stabbing pain attacks in the face due to damage to the trigeminal nerve. The trigeminal nerve carries sensations such as touch, temperature and pain from the face to the brain. Trigeminal neuralgia is usually one-sided and may cause sudden, severe pain triggered by simple activities such as speaking, chewing or even a light touch.

This condition is generally seen in people 50 years and older, but it can also occur in younger individuals. The pain of trigeminal neuralgia is described as electric-shock-like, stabbing or sharp and may last from seconds to minutes. Although rare, it has a major negative impact on quality of life, and affected individuals seek treatment to relieve pain.

What Triggers the Pins-and-Needles Sensation in the Face?

The “pins-and-needles” sensation in the face usually arises from abnormal nerve function. This sensation can be associated with conditions such as trigeminal neuralgia. When the trigeminal nerve is compressed, it can send abnormal signals to the brain, leading to sensations such as pins and needles, tingling or numbness. In addition, demyelination — damage to the nerve sheath called myelin — can also trigger these abnormal sensations.

Causes of the Pins-and-Needles Sensation

• Trigeminal Neuralgia: If the trigeminal nerve is affected, individuals may experience severe, stabbing pain or a tingling sensation in the face, often triggered by a light touch or small movements.
• Nerve Compression: When a blood vessel compresses the trigeminal nerve, normal nerve transmission can be disrupted and lead to a stabbing sensation.
• Multiple Sclerosis (MS): MS is an immune system disease that damages the myelin sheath around nerves and can cause abnormal nerve signals and pins-and-needles sensations.
• Infections: Infections such as shingles, or other viral diseases, can also cause nerve inflammation that leads to pins-and-needles sensations.
• Vitamin Deficiencies: Particularly B12 deficiency can cause nerve damage and produce numbness or tingling in the body, especially in the face.

What Are the Symptoms of Trigeminal Neuralgia?

The main symptom of trigeminal neuralgia is severe, stabbing pain in the face, usually one-sided. The pain is described as:

• Sharp, stabbing pain: Often described as an electric shock or burning.
• Burning pain: In some individuals there may be a continuous burning or aching sensation, although it is usually not as severe as the stabbing pain.
• Tingling or numbness: At times the “pins-and-needles” sensation may accompany the pain.

Triggers of these pains include:

• Speaking or chewing
• Brushing teeth
• Touching the face or a light breeze on the face

Other common symptoms:

• Short, sudden severe pain (lasting seconds to several minutes)
• Pain in specific areas — e.g., jaw, cheek or around the eye
• Chronic pain — pain attacks becoming more frequent over time.

What Causes Trigeminal Neuralgia?

Trigeminal neuralgia usually occurs as a result of one of the following:

• Vascular compression of the nerve: The most common cause is a blood vessel (usually an artery or vein) pressing on the trigeminal nerve. This pressure can prevent the nerve from working properly and lead to severe pain through abnormal signals.
• Multiple Sclerosis (MS): MS damages the myelin sheath around nerves and can prevent the trigeminal nerve from functioning properly, leading to symptoms resembling trigeminal neuralgia.
• Tumors: Tumors can rarely compress the trigeminal nerve and cause trigeminal neuralgia symptoms.
• Other Conditions: Diabetes can damage nerves and blood vessels and cause trigeminal neuralgia.

Why Does Pain Develop on the Left Side of the Face?

Nerve pain or a pins-and-needles sensation on one side of the face (particularly the left) may have many causes. Trigeminal neuralgia is at the top of the list. Other possibilities include:

• Dental health problems: An abscess or dental infection on the left side of the teeth can cause pain referred to one side of the face.
• Sinus problems: Infection or inflammation of the sinuses can cause pain or tenderness on one side of the face.
• Temporomandibular Joint (TMJ) disorder: Dysfunction of the jaw joint can cause one-sided facial pain that resembles trigeminal neuralgia.
• Cluster headaches: This type of headache causes severe pain usually on one side of the face or head and can be confused with trigeminal neuralgia.

Treatment Options for Trigeminal Neuralgia

If you think you have symptoms of trigeminal neuralgia, it is important to seek professional help.

• Medication: The first-line treatment is usually anticonvulsant drugs that calm nerve activity. Exercise, yoga, meditation and biofeedback may support drug therapy.
• Surgical Treatment: If medications fail, surgical intervention may be considered.
• Nerve Block Injections: In some cases, injections to the nerve can relieve pain. Botulinum toxin A injections can also reduce pain.

Trigeminal neuralgia is a painful condition that often disrupts daily life and can cause sharp, stabbing and burning pain on one side of the face — including a pins-and-needles sensation. If you experience facial pain or a tingling sensation, it is important to consult a healthcare professional for correct diagnosis and appropriate treatment. Various treatment options are available to manage this condition and relieve pain, regardless of whether it is due to nerve compression, MS or other factors.