MS and Trigeminal Neuralgia: Is There a Link?

Medically Reviewed by Christopher Melinosky, MD on September 06, 2022
3 min read

Trigeminal neuralgia, which is a type of chronic nerve pain in your face, is common with multiple sclerosis (MS). It may feel like a stabbing or burning sensation on the side of your face.

People who don’t have MS sometimes have trigeminal neuralgia, but it’s more common with MS. About 4% to 6% of people with MS have it, which is about 400 times more than people without MS.

Trigeminal neuralgia may be an early symptom of MS. In one study, 15% of people had it before they were diagnosed with MS.

When you have MS, your immune system attacks myelin. Myelin is a substance that surrounds your nerve fibers and helps them send fast electrical impulses to your brain.

When your myelin sheath is damaged, which is called demyelination, you may get spots, or plaques, with no myelin. That can lead to neurological symptoms like loss of vision, sensations, and motor functions. When your trigeminal nerves are damaged, it’s called trigeminal neuralgia.

The longer you have MS, the more likely you are to develop trigeminal neuralgia. It’s most common in your 50s. It’s rare for people under 40 to get it. When they do, it’s most likely linked to MS. Women may have a higher risk.

For people without MS, trigeminal neuralgia usually results from a blood vessel pressing on a nerve in your skull. If you have MS, the cause is usually from damage to your myelin sheath. An MRI can help your doctor decide if MS or a tumor is causing your problems.

Trigeminal neuralgia is chronic pain you feel in your face. It stems from your trigeminal nerves, which carry signals from your face to your brain.

You have a trigeminal nerve on either side of your face. Each nerve branches out into three parts. You may feel pain in one or more of the nerve branches. It’s different for everyone.

It can hurt when you eat or drink, or during everyday activities like brushing your teeth, shaving, or putting on makeup. Sometimes talking, kissing, smiling, or moving your head can trigger it. Other times it results from things like the wind, a cool breeze, air conditioning, or hot, cold, or spicy food.

Your pain may be extreme. It could feel like a burning or searing pain or an electric shock. It can come on suddenly, without warning, or come in waves. The pain may last a few seconds or a few minutes, or it may be a chronic pain that doesn’t go away.

Although trigeminal neuralgia is a long-term condition with no cure, you can manage the pain with treatment.

Painkillers like aspirin and ibuprofen typically don’t help with trigeminal neuralgia, so your doctor may prescribe other medications to help with nerve pain or relax your muscles. They include:

  • Baclofen (Lioresal)
  • Carbamazepine (Tegretol)
  • Gabapentin (Neurontin)
  • Lamotrigine (Lamictal)
  • Oxcarbazepine (Trileptal)
  • Pregabalin (Lyrica)

The doctor may send you to a pain specialist or neurosurgeon to discuss other treatment options, like surgery.

You can also try complementary and alternative therapies, like acupuncture, massage, meditation, and yoga, to manage pain.

Scientists are looking for more ways to treat trigeminal neuralgia.

If you have trigeminal neuralgia symptoms, talk to your neurologist. The doctor can prescribe medication to ease your pain or refer you to a specialist.

Other medical professionals can help you manage living with trigeminal neuralgia. An occupational therapist can help you with daily activities like eating and drinking. A pain specialist can recommend specific treatments. A therapist or psychologist can help you manage sleep problems, depression, and feelings of isolation, which are common with trigeminal neuralgia.