What causes trigeminal neuralgia (TN)?

The underlying cause for most cases of trigeminal neuralgia is pressure on the trigeminal nerve. The pressure usually occurs from a loop of a blood vessel, usually one of the normal blood vessels that go to the area of the brain called the brain stem. It’s often an artery called the superior cerebellar artery. It can also be the anterior inferior cerebellar artery. What we believe happens is that as arteries elongate, and elongation of arteries is something that happens with age, a loop of the artery comes in contact with the nerve, distorts it, and causes a rubbing away or a degradation of the insulation of the nerve fibers. The nerve fibers short-circuit, and that's what results in this electric-shock-like pain.

Trigeminal neuralgia is caused by an improperly functioning trigeminal nerve. What causes the trigeminal nerve to act up though is not always clear. Often, it is the result of an artery or vein that runs near the nerve, touching or pressing against it, causing pressure. It can also develop as a result of nerve damage caused by multiple sclerosis, and less frequently, as the result of a tumor putting pressure on the trigeminal nerve.

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