Anesthesia Dolorosa: What Happens if the Trigeminal Nerve is Damaged?

Whether you have been diagnosed with anesthesia dolorosa or are learning about it as a potential side effect of medical treatment, the following information will help you understand the condition better. Read on for more about anesthesia dolorosa, what happens when the trigeminal nerve is damaged and how it can be managed.

What is Anesthesia Dolorosa?

Translated from Latin, anesthesia dolorosa means “painful numbness.” It occurs as a result of injury to the trigeminal nerve, which is the nerve responsible for transmitting sensation from the face to the brain. This could be following intentional injury to the trigeminal nerve in an attempt to alleviate trigeminal neuralgia pain, or it could be incidental during another treatment, like surgery to remove a tumor.

If you are about to undergo treatment for a procedure with a risk of anesthesia dolorosa, it’s particularly important you understand the condition. This will help you make an informed decision about your treatment and whether the benefits outweigh the risks. Your doctor will be the best person to discuss these risks with you, as they depend on your condition, the form of treatment and your individual health profile. 

What are the Symptoms of Anesthesia Dolorosa?

The name of the condition accurately describes the primary symptom: painful numbness. If your doctor suspects anesthesia dolorosa, he or she will consider your symptoms and past history of medical procedures affecting the trigeminal neuralgia to form a diagnosis. There are no blood tests or x-rays to screen for the condition.

Symptoms of anesthesia dolorosa include:

  • Numbness and inability to feel touch, hot or cold on all or part of one side of the face
  • Constant pain in the area of numbness which occurs without stimulation and does not subside
  • Pain that is described as burning, tingling, chemical, ice cold or electric
  • Some patients also feel pressure, tugging, heaviness or tightness in the area

How Does Anesthesia Dolorosa Happen?

Anesthesia dolorosa occurs after the trigeminal nerve is damaged during a medical procedure. It could be chemical trauma, physical trauma or radiation trauma, depending on the treatment modality. But the common theme is that something has damaged the nerve, leading to numbness with constant pain.

What Happens if the Trigeminal Nerve is Damaged?

It may seem confusing that damage to the trigeminal nerve wipes out touch sensations but creates pain. Why isn’t everything simply numb? Research is still being conducted to better understand the underlying cause. However, there are currently three theories about the mechanism of anesthesia dolorosa:

  1.   Something has injured the nerve fibers that transmit touch sensations, but pain fibers are still intact.
  2.   The fibers within the nerve have been damaged and no longer overlap in proper alignment, confusing the brain with jumbled sensory signals.
  3.   Anesthesia dolorosa pain is similar to phantom limb pain. The last signals the brain received were painful. Now, with no incoming input, the brain is remembering and continuing to feel pain.


Keep in mind that these are simply theories at this point. Though clinicians and researchers are working hard to understand anesthesia dolorosa, the mechanism is still undefined.

How is Anesthesia Dolorosa Managed?

Unfortunately, there is no simple answer to address anesthesia dolorosa. Further intervention is typically contraindicated, as that may aggravate the problem rather than alleviate it. The most common form of treatment is pharmacological, using medications that also help provide relief from trigeminal neuralgia. These include tricyclic antidepressants, muscle relaxers and anti-seizure medications. Patients have been treated with these medications and found partial or even complete relief from their pain. 

Another form of treatment is using electrical stimulation delivered to specific areas of the brain. Though a novel treatment still under investigation, some patients have had their pain successful alleviated using electrical brain stimulation.

It’s important to understand that doctors don’t currently have a method for repairing chronic nerve damage. If you have been diagnosed with anesthesia dolorosa, treatment involves managing symptoms, not curing the disease.

Discuss Anesthesia Dolorosa with Your Doctor

If you are considering your treatment options for trigeminal neuralgia or another surgery and anesthesia dolorosa is a risk, be sure to discuss the issue with your personal doctor. Part of the informed consent process is understanding how the benefits of a medical treatment compare to the risks. Your doctor will be able to explain the likelihood of anesthesia dolorosa occurring based on the condition you are having treatment and the approach used.

If you have already undergone treatment and are now experiencing anesthesia dolorosa, it’s still just as important to have open communication with your doctor. If your doctor does not have experience with the condition, ask for a referral to someone who does. He or she can help evaluate your symptoms and develop a treatment plan to help provide relief from the pain your experiencing.

Regardless of which situation you are in, continue to educate yourself. You’ve already taken steps to learn more about anesthesia dolorosa, and you should have a deeper understanding of the condition at this point. Whatever your situation, increasing your knowledge can help you have confidence as you move forward along your personal health journey. Be sure to bring up any lingering or new questions you have with your doctor so he or she can help you resolve any concerns you may have.

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.

Get Your Questions Answered, By a Real Person.

Our Patient Liaison is here to help you understand your next step. After discussing your specific case, she can help you navigate your medical records, answer insurance questions, and connect you with one of our nurses, at no charge to you.

Patient liaisons explain Gamma Knife surgery cost, outcomes, etc.