Trigeminal Neuralgia occurs as an intense lancinating pain which shoots into the face. The pain may occur in a fairly small area of the face or it may spread rapidly over a fairly wide area, but is always confined to the face. (That is, to the distribution of the Trigeminal nerve.) Pain which spreads across the mid-line, over the back of the scalp or into the neck is not consistent with Trigeminal Neuralgia. Trigeminal Neuralgia very rarely may occur in both sides of the face.
The pain occurs suddenly as a brief episode usually lasting a few seconds at a time, sometimes lasting up to a minute before it passes, to return moments later in the same fashion. These brief episodes may thus be repeated over and over again for a long time as an attack of Trigeminal Neuralgia or may occur in isolation as a single episode. The attacks of pain may be set off by minor everyday events such as a light touch to a "trigger area" which the patient soon learns to avoid. Often talking, eating, drinking, brushing teeth or shaving will set off an attack of pain, even a gentle draught on the face may be enough to send the patient into yet another agonising attack of his affliction. It is difficult to measure pan, but many will agree that Trigeminal Neuralgia can be the worst pain known to man or woman.
The attacks of pain may return at frequent intervals, and this may persist as an episode of Trigeminal Neuralgia lasting weeks or months, then, for no apparent reason, the condition subsides, leaving the patient free of pain for months or even years before it returns to reproduce the same pattern of events. A patient who has had Trigeminal Neuralgia can expect that it will one day return if left untreated. Over time the attacks tend to become more frequent and last longer until the patient finds himself in a state of perpetual agony, be it the agony of an attack or the agony of the fear of the next attack which he has learned will surely come.
Early in the progress of the condition, the periods between the episodes of pain are pain freer as time goes on however the patient may be left with a dull ache or burning sensation in the face which is continuous.