Does Stress Cause Trigeminal Neuralgia

Understanding your trigeminal neuralgia is a powerful way to help manage your condition. Recognizing and reporting your symptoms is important during the diagnosis process. Knowing a little about the underlying cause and anatomy can demystify some of the ins and outs of different treatment options. The information below briefly explains more about the condition, including its symptoms, whether or not stress causes it and what your trigeminal neuralgia treatment options are.

What is Trigeminal Neuralgia?

Trigeminal neuralgia is a chronic condition characterized by extreme facial pain in response to normal activities. Patients typically experience symptom-free periods, then suffer attacks of pain. These attacks can be so severe and debilitating that the condition has been called the “suicide disease.”

Before going any further, it may be helpful to review the anatomy related to the condition. The term neuralgia means recurring pain along a particular nerve. The trigeminal nerve is one of the cranial nerves, which occur in pairs on the right and left sides of the body. This nerve is responsible for transmitting sensory information from the face to the brain, including touch, temperature and pain. The trigeminal nerve has three divisions: V1 supplies the upper third of the face with nerves, V2 supplies the middle third and V3 supplies the bottom third.

What are the Symptoms?

The primary symptom is pain. Unfortunately, there are no diagnostic tests like x-rays or blood work to test for trigeminal neuralgia. Your doctor will consider your symptoms and rule out other diseases before coming to a formal diagnosis. The unfortunate fact is all patients with trigeminal neuralgia will experience symptoms; without them, there would be no diagnosis.

The pain associated with trigeminal neuralgia typically has the following characteristics:

  • Sharp, stabbing or electric facial pain in response to non-painful stimuli (like smiling, brushing your teeth or gentle touch) that lasts seconds or minutes
  • Periods without pain, alternating with attacks that increase in duration and frequency over time
  • Some patients experience an aura, tingling or a dull ache before the onset of an attack
  • Rarely, in patients with atypical trigeminal neuralgia, the sharp pain is constant and unyielding 

What are the Causes?

Trigeminal neuralgia used to be very difficult to diagnose and treat. However, doctors now have a better understanding of its cause. Recall that the trigeminal nerve is one of the cranial nerves, which branches off the brain and leads to the face. The most common cause of trigeminal neuralgia is a small blood vessel near the brain pressing on the nerve. This pressing creates a situation where the information transmitted about normal sensations, like touch or a cool drink, is misinterpreted as a pain signal, leading to symptoms.

Though a deviating blood vessel is the most common cause, other factors can contribute to trigeminal neuralgia. Sometimes it’s another structure, like a tumor, that presses on the trigeminal nerve. Another cause is demyelination, a process where the nerve loses its protective sheath that sometimes occurs in conditions like multiple sclerosis. Finally, although rare, sometimes there is no obvious identifiable cause.

Does Stress Cause Trigeminal Neuralgia?

There are different types of stress, and the way you respond to it is a very individual process. Stress can be physical, psychological and emotional. Part of the stress response is physiologic, with your body responding in a predictable way to what you are experiencing. However, an important and very personal psychological response modulates how you react to different stresses.

While stress alone doesn’t cause trigeminal neuralgia,  stress can aggravate the condition. There isn’t a lot of understanding about how or why, but one possibility is the relationship between stress and pain. Studies have shown that chronic pain can lead to stress-induced heightened pain sensitivity. That means the body is even more sensitive to pain than usual. This can lead to a snowball effect where patients experience severe pain and, when not in pain, may have high anxiety and avoid certain activities out of fear of pain.

Reducing Your Stress May Help

Because stress has such a subjective element, its contribution to trigeminal neuralgia pain can be difficult to quantify. However, reducing your stress and anxiety may help prevent the onset of an attack, and it certainly won’t hurt. What helps you relieve stress isn’t going to be the same as the next person’s. That said, there are things you can do as they relate to your condition that may help. These include:

  • Continue to educate yourself. Learning more about trigeminal neuralgia and your treatment options can help you feel a sense of control when you might otherwise feel helpless against your pain.
  • Work with an expert who understands available trigeminal neuralgia treatment options. Knowing you are in good hands will help you rest easy throughout the process.
  • Speak to other patients, whether in person or online. You aren’t alone, and it can be comforting to hear from other people who have shared your experiences.

Trigeminal Neuralgia Treatment Options

There are a few different options for trigeminal neuralgia treatment. Your doctor will work with you to develop the best plan for your specific case. Potential trigeminal neuralgia treatments include:

  • Trigeminal Neuralgia Surgery: During procedures such as microvascular decompression, blood vessels that impact the trigeminal root are relocated or removed to restore the proper function of the nerve.
  • Stereotactic Radiosurgery: A focused beam of radiation is delivered using technology such as Gamma Knife in an easy, outpatient setting. This is the least invasive and the least likely of all surgical treatments to cause complications.
  • Medications: For patients who are not candidates for surgical procedures, anti-seizure drugs, muscle relaxants or tricyclic antidepressants may be prescribed to relieve pain and reduce the number of attacks.

Continue the Discussion with Your Doctor

Take the information you’ve learned and continue the discussion with your personal doctor. He or she can discuss your individual experience and stress factors, and together you can come up with a plan to help reduce stress in your particular case. If you still have lingering questions, be sure to write them down and bring them up at your next appointment. Having peace of mind is going to help throughout this process, and your doctor is there to help answer your questions and alleviate your concerns.

Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Dr. Anthony D’Ambrosio is a board-certified neurosurgeon that specializes in Neurosurgery, Stereotactic Radiosurgery, Gamma Knife Radiosurgery (GKRS) and more. He is the Director of Neurosurgery and Co-Director of the Gamma Knife Program at The Valley Hospital. Dr. D’Ambrosio is an expert in treating patients with trigeminal neuralgia, benign or malignant brain tumors, as well as many other neurological conditions.

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