Branch 2 (Maxillary): goes towards the cheeks, nose, upper lip, upper teeth.
Branch 3 (Mandibular): goes towards the jaw, chin, lower teeth, tongue.
When you have neuralgia, it’s usually only ONE nerve branch that’s affected. That’s why the pain is on one side of the face—it’s not bilateral (on both sides).
According to the , the right side is more frequently affected (60%), and bilateral cases represent only between 1 and 6% of the total. In 90% of cases, the second or third branch of the nervous system is affected. The first branch is rarely involved (note this).
Comparative table: Trigeminal neuralgia vs. other common facial pains
| Feature | Trigeminal neuralgia | Migraine | Toothache | Sinusitis |
|---|---|---|---|---|
| Duration of pain | Seconds to 2 minutes | 4 to 72 hours | Continuous or pulsatile | Persistent days |
| Type of pain | Electric, sudden burst | Pulsating, oppressive | Dull or sharp | Pressure, facial weight |
| Affected area | One side of the face | One side of the head | Tooth or jaw | Cheeks, forehead, nose |
| Trigger | Touch, chew, wind | Light, noise, stress | Cold, heat, pressure | Without a clear trigger |
| Between attacks | Painless (in type 1) | Painless | Continuous pain | Persistent discomfort |
| Usual diagnosis | Neurologist + MRI | Neurologist | Dentist | Clinical / ENT |
| Intensity (1–10) | 9–10 / 10 | 6–8 / 10 | 5–7 / 10 | 4–6 / 10 |
The Symptoms (How to Know If You Have It)
Pain is the main characteristic. BUT it’s not just any pain. It’s specific:
Pain in short bursts: It lasts seconds to a maximum of minutes. Rarely more than 2 minutes. But it is EXPLOSIVE. It appears suddenly, without warning.
Electric pain: It feels like a lightning bolt, a shock, pure electricity. Burning. Sharp. Some describe it as if someone were stabbing you in the face.
Triggers: The pain is triggered by the smallest things. Touching your face. Talking. Chewing. Brushing your teeth. Even wind in your face. Some patients are afraid to eat because every chew triggers the pain.
Specific areas: It always hurts on the SAME side of the face. And in the SAME area — cheek, jaw, or forehead. It doesn’t move.
No symptoms between attacks: After the pain, you feel fine. Until it returns. It could be minutes or hours later.
It affects only one side: IMPORTANT: It’s always one side. If both sides hurt, it’s probably not trigeminal neuralgia.
Why It Happens (The Real Causes)
The most common cause is vascular compression . A blood vessel is rubbing against the trigeminal nerve. Every time your heart beats, the vessel rubs against the nerve. The nerve becomes irritated and sends a pain signal.
It’s like having an old telephone cable, and someone is constantly passing something over it. The cable gets damaged.
