Trigeminal Neuralgia

Trigeminal neuralgia causes electric shocks of facial pain. Alongside your neurology team, we address nerve irritation, inflammation, myelin support, and brainstem regulation.

What you may be noticing

Sudden, electric, stabbing pain in the cheek, jaw, teeth, gums, or around the eye, usually on one side. It lasts seconds, then strikes again. Brushing your teeth, chewing, a breeze across your face, or applying makeup can set it off. Between attacks you may feel fine, yet you live braced for the next one.

New facial pain needs a medical evaluation, including imaging, to identify the cause. I never ask anyone to change or stop a prescribed medication.

Why it is rarely one thing

The trigeminal nerve carries sensation from the face to the brainstem. In classic trigeminal neuralgia, a blood vessel presses on the nerve root near the brainstem, wearing the protective myelin and allowing signals to short-circuit. Multiple sclerosis can produce the same pattern through demyelination. Some cases have no visible cause.

Even when compression is present, the nervous system around it matters. Not only a compressed nerve, but a nerve whose threshold, myelin health, and central processing determine how easily it fires. Inflammation, nutrient deficiencies, and a sensitized brainstem may lower that threshold, a working hypothesis, since research on these contributors is limited.

The brain is the master system here as everywhere. Pain is processed in the brainstem nucleus of the trigeminal nerve, which also receives input from the upper neck. When that region is calmer and better supported, the whole circuit has more margin. Attacks often cluster for weeks, then remit for months, so tracking triggers, sleep, stress, and diet helps your care team time medication or procedures well.

Patterns we look for

• MRI findings, including vascular compression or demyelination.
• B12, folate, and methylation status, which support myelin.
• Vitamin D and inflammatory markers.
• Dental and jaw contributors that mimic or aggravate facial pain.
• Herpes virus history, including shingles in the face.
• Cervical and upper neck input, which converges with trigeminal pathways.
• Central sensitization and autonomic overdrive.
• Sleep loss and stress chemistry that lower pain thresholds.

How I evaluate it

The comprehensive functional neurological exam maps facial sensation, corneal and jaw reflexes, cranial nerve function, eye movements, and cervical mechanics. It helps distinguish trigeminal neuralgia from TMJ dysfunction, dental pain, and occipital patterns.

Functional labs may include B12 with methylmalonic acid, folate, homocysteine, vitamin D, inflammatory markers, and a metabolic panel. I coordinate closely with your neurologist and any surgical team. Atypical features, such as constant burning pain, numbness, or symptoms on both sides, call for further imaging and specialist review.

How we address it

We regulate before we stimulate, because a sensitized nerve needs safety before challenge.

1. Keep your neurology team central, including medication and procedural options.
2. Calm central sensitization first with slow breathing, vagal tone training, and protected sleep.
3. Support myelin with methylation nutrients and omega-3 fats where indicated.
4. Reduce systemic inflammation through food as medicine and a cleaner terrain.
5. Address dental, jaw, and upper cervical contributors.
6. Add gentle brainstem-based rehabilitation that stays well away from your trigger zones.

You deserve a face that can feel the wind again without fear.

Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.