A 46-year-old woman once visited our clinic with severe facial pain.
She looked exhausted — not just physically, but emotionally too.
She had already visited multiple dental clinics over the past several months. Thinking it was a tooth problem, she had undergone different dental treatments, but the pain never truly disappeared.
The pain was sharp, sudden, and unbearable at times. Even simple activities like talking, eating, or brushing seemed to trigger it.
Like many patients, she believed it was dental pain. And honestly, many dentists initially thought the same.
But after careful examination and detailed history-taking, my senior doctor suspected something else:
It was not a toothache.
It was trigeminal neuralgia.
What is trigeminal neuralgia ?
A sudden, usually unilateral, severe, brief, stabbing, recurrent pain in the distribution of one or more branches of the trigeminal nerve.
Clinical Features of Trigeminal Neuralgia
-
Nature of Pain
Sudden, severe, sharp, stabbing or “electric shock–like” pain
Pain occurs in short attacks or paroxysms
Each episode usually lasts from a few seconds to about 2 minutes -
Site of Pain
Usually unilateral (one side of the face)
Most commonly affects:
Maxillary division (V2)
Mandibular division (V3)
Ophthalmic division (V1) is less commonly involved -
Trigger Factors
Pain may be triggered by mild stimulation such as:
Brushing teeth
Washing face
Talking
Chewing
Shaving
Cold air or light touch
These areas are called trigger zones. -
Frequency
Attacks may occur many times a day
Pain-free intervals may occur between episodes -
Age and Gender
Common in middle-aged and elderly patients
More common in females -
No Neurological Deficit
Usually no sensory loss or swelling
Clinical examination is generally normal -
Misdiagnosis
Often mistaken for dental pain
Many patients undergo unnecessary dental treatment before correct diagnosis.
One of the most well-known public figures who openly spoke about trigeminal neuralgia is Salman Khan.
He revealed that he suffered from severe facial pain, and undergone gamma knife surgery, in US
In one interview, Salman Khan said:
“You would not want your biggest enemy to have that pain.”
There is no cure to trigeminal Neuralgia,
A correct diagnosis may not erase pain overnight, but it can save patients from months or even years of unnecessary suffering.
MBH/PS