Trigeminal Neuralgia and Stroke

The severe facial pain of a condition called trigeminal neuralgia is so unusual that people who have trigeminal neuralgia mistake it for a stroke. Trigeminal neuralgia is not a stroke. It is a medical condition that causes part of the face to be highly sensitive to touch and extremely painful even when it is not being touched. 

Each side of your face obtains its sensory function through a nerve called the trigeminal nerve.

Trigeminal neuralgia is caused by damage or irritation of the trigeminal nerve, and this is what gives the condition its name. 

Facial pain and stroke 

Pain in the face is almost never the only sign of a stroke. Head pain can be a sign of stroke, but even when headaches are a signal of a stroke, the headaches are accompanied by other neurological problems. 

The facial pain caused by trigeminal neuralgia is so distressing that many individuals who suffer from trigeminal neuralgia become concerned about a stroke. It certainly is a good idea to see your doctor if you experience severe facial pain, and you will likely have a referral to a neurologist; a doctor specialized in brain and nerve problems. But, if you are diagnosed with trigeminal neuralgia, your care will be focused on taking care of your pain and not on a stroke. 

What is trigeminal neuralgia? 

Trigeminal neuralgia occurs in healthy adults and is one of the most common types of facial pain.

The throbbing, burning pain affects one whole side of the face or the upper, middle or lower part of one side of the face. Trigeminal neuralgia can produce constant pain or it can produce pain that comes and goes. It can even quiet down for months and then flare up again. Most of the time, if it is not treated by medication or surgery, there will be some constant facial pain in the background even when it isn't flaring up.


Trigeminal neuralgia can be triggered by irritation of the facial nerve, often occurring as a result of dental work or surgery in the facial area. However, sometimes there is no explanation for why someone gets trigeminal neuralgia. 

There are several medical treatments, including over the counter painkillers and prescription medications that are normally used for nerve pain. The most commonly prescribed of these medications include carbamazepine and gabapentine, which are known as anti-seizure medications. When used for trigeminal neuralgia, these medications are used to 'calm down' the nerve activity to reduce the pain. Creams that contain painkillers are popular among trigeminal neuralgia patients, but are not usually helpful for the most severe pain. Nevertheless, creams are safe to use as long as they don't get into your eyes or ears, and some patients notice improvement with creams. 

Surgery can also help reduce or eliminate the pain of trigeminal neuralgia. In trigeminal nerve surgery, the trigeminal nerve or a portion of the trigeminal nerve is deliberately cut to get rid of the pain.

Often, after surgery for trigeminal neuralgia, the normal sensation of the face is reduced or lost, but in cases of severe pain, most patients think it is worth it. 

Does trigeminal neuralgia mean I will have a stroke?

People who have trigeminal neuralgia are not at an increased risk of having a stroke, and the medications used for trigeminal neuralgia do not increase the risk of stroke. 

There are rare instances in which there could be a serious underlying cause of trigeminal neuralgia- such as a brain tumor or a brain aneurysm. Your doctor will look for those causes and rule them out before giving you a diagnosis of trigeminal neuralgia.


Weiner, William J., Goetz, Christopher G, Neurology for the Non-Neurologist, Fifth Edition, Lippincott Wiliams& Winkins, 2004

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