Migraine and Trigeminal Neuralgia

By Editorial Team

2 min read

Last updated: October 2023

Trigeminal neuralgia (TN) is a chronic pain disorder that causes sudden, severe facial pain. This pain is usually on 1 side – but can sometimes be on both sides – of the face. TN is the most common kind of facial pain in people 50 years or older. It is also more common in women than in men.^1-3

TN happens because of an issue with the trigeminal nerve. This is a major nerve branch that allows your brain and face to communicate about touch and pain. In TN, the trigeminal nerve is often injured or unable to communicate properly with the brain. This can cause it to transmit pain signals too frequently.^1-3

What are the symptoms of TN?

The main symptom of TN is sudden, intense pain typically on only 1 side of the face. This pain< often feels like a sensation that is any of the following:^1,2

Burning
Throbbing
Shooting
Aching

You may also feel numbness or tingling. Pain attacks typically focus on the lower face and jaw. But the pain may also sometimes spread to the area around the nose or eyes.^1,2

What are the different kinds of TN?

There are 2 types of TN. Type 1 is the “classic” type of TN. It causes extreme, sudden, and burning or shooting facial pain that can last from a few seconds to 2 minutes. Multiple TN attacks can happen close together, in periods of up to 2 hours. Type 2 TN is a constant, usually less severe, burning or stabbing pain. It is a less common form of TN.¹

It is possible to have both Types 1 and 2 TN at the same time. In both types of TN, attacks often cluster together before symptoms pause for a period of time.¹

Sometimes, TN is progressive. This means attacks can become more severe or more frequent as time goes on.¹

What is TN’s connection to migraine?

Studies have shown people who have migraine attacks are more likely to develop TN than those who do not. In 1 study, the rate of people with migraine who develop TN jumped from 20 in 100,000 people in a year to 137 in 100,000. This increase suggests having migraine may put someone at greater risk for TN.³

Not much is understood about how TN and migraine are linked. The exact mechanisms are unknown, but some experts believe that the trigeminal nerve may be involved. Migraine can cause inflammation in the tissue around the trigeminal nerve. The trigeminal nerve receives these inflammatory signals and becomes inflamed as well. This can cause the nerve to become irritated.³

People with migraine and Type 2 TN may have a hard time telling the 2 conditions apart. Type 2 TN can cause more pain in the head. Type 2 TN is easier than Type 1 TN to be confused with migraine. This is because Type 1 TN tends to cause more pain in the face. This is why other causes of pain should be considered for people who have migraine.²

If you have migraine and suspect that you may have TN, talk to your doctor about your symptoms and the best options for you.²

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That explains earache and jaw pain with migraine.
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Great, now can you help in distinguishing seizures from migraines lol I'm diagnosed with all three: TN, seizure disorder, and migraines. At times I feel they're all going on at the same time. How can I tell one from the other when they're meshing like this? And how can I be sure I have been properly diagnosed?
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What are some of the treatments for patients that have been dx'd with tn and migraine?
1. not found
 They have been treating me with nerve blocks as of yet haven't found the right block but as all of us do we just keep plugging along and praying that soon relief will be with us.
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The more I research this disease the more I realize I have been misdiognosed all my life. Its not easy living like this!
1. not found
 I still pray for you everyday remember keep your head up 
2. not found
 Thank you! I will!! God will guide my steps and give my doctor the wisdon...from now on!
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Thank you. I'm classic TN. 27 years of migraines. I can make the distinction with the two disorders. I cannot relate "shock" pain. It's more like '...it hurts like f... he..." An 8.5. The whole side of face, head. The disease has progressed pretty far. Last episode lasted for 12 days. I have nerve damage, numbness in my cheek. I can actually feel the pain in the middle of my head constantly, a 2. Tolerable. Yesterday, I found out my mother has it, grandfather had it. I'm glad I've had my migraines under control the last two months (hormone therapy and less stress), otherwise I would have attributed it to the migraine. Probably didn't need that root canal 5 years ago. We spent a lot of time try to find out which tooth hurt because I wasn't sure. I have to figure out the new triggers. More research is needed for this disorder. It's not rare. It is hereditary. Best relief is a ice cream shake or anything viscous you can suck through a straw and have it hang in the back of your throat. Mother uses ice cubes. Works better than praying. I hate morphine derivatives, it's like drinking a pot of coffee. I inevitably hurt my back or neck when I take it. Back is a mess too. Thank you again and I wish everyone well.
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Sometimes, I just cry when I think about how much pain I have endured. I cry about the look of disbelief that I really am in the depths of agony that I say I am. I have only lived 1/2 my life. I'm haunted by what might have been.
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How do you differentiate? Why would you differentiate? As a person with migraines, I am grateful if I only feel a brief, if very sharp pain. They are just part of the spectrum of pain and over-sensitivity migraineurs live with.
1. 91q65e Member
 I am 50 years old and I have had migraines since i was about 5. My trigeminal problem started when i was 44 or 45. All of a sudden while just sitting watching tv, the pain hit my left jaw bone. It was like someone had ahold of my jawbone and was trying to tear it out of my head. This progressed over the next year and a half. The pain also started to affect my left ear, all the teeth on the left side,face, forehead, the front half of the left side of my head and my left eye. I was taking 1800 mg of nurotin every day. One day while I was outside for quite awhile I thought I was getting a migraine so I came in and laid down. It was not a migraine but all three sections of that nerve making everything i listed above to hurt all at the same time. The pain never stopped, my eyeball hurt so bad and would start twitching. I made myself make it through Thanksgiving and Christmas and the year end bills and taxes. For three months the pain never stopped and got even worse. I called my neuroligist and her office said she couldn't see me for 3 months. I seriously wanted to die and thought about making it happen all the time. I called her assistants phone and left a message, my neuroligist called me within 10 minutes and upped my neurotin to 2400 mg and had me come to office the next day. She set me up with a surgeon and I had cranial surgery within three weeks. I never in my wildest dreams thought I would ever rather have a migraine. It is hard to imagine but trigeminal face and head pain even for a short few minutes IS worse than having a migraine. I have a cluster of veins wrapped around the nerve up close to where it exits the brain and they put an enormous amount of padding between the nerve and veins to take pressure off. I still have pressure somewhere in there but the pain is a LOT better.
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Its interesting to know the name of this phenomenon. I had not idea it was related to migraine. I've had this, even as a child, when I'm over tired or stress.
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I had a craniotomy for the Trigeminal Neuralgia and I also have Migraines, and I tell you, life can get disheartening when you are constantly hurting. I truly understand the agony of TN and the sharp pains in the face from wind blowing on you or just brushing my teeth , you never know when its going to act up. The Migraines have gotten worse I think since my surgery, and my senses have become extremely heightened, which is not good for migraine triggers. So I feel my quality of life has declined, but I put my hope and trust in GOD for he keeps me daily. Your all in my prayers , I do know the suffering you go through, your not alone.
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Hello, My name is Maryanne and I was just diagnosed with TN on the 20th day of March of this year.I have been having a lot of headaches that wouldn't go away.I was feeling quit dizzy, and sick too my stomache. I couldn"t remember anything over time. I was starting too show a lot of different things neuroigolly. I had gone through several tests to detrimed, in what was really going on. I had gone through a EMG which is a test that is done with needles, being put in your legs to test your nerve waves,. with this test they also test your nerves by shocking them..They had put needles in your back too rules out MS..I also had a MRI done to see if there was any tumor's..Gratefully there wasn't no sign's of tumor's...I also had a block for the pain, and it help for 6 hour's but by the next day around 11 and 12 pm I was starting to feel the pain again... But what is so funny about this whole thing..I have a sister that has TN as well and she has been going through it for many years..So we share the samething and we both can go through this together and help one <a href='http://anther.who' target='_blank' rel='noopener noreferrer ugc'>anther.who</a> would ever know that two people in the same family, would be going through the samething..she has TN on the inside nerve and I have it on the outside of the nerve. My sister as it all through her face and the pain gets to be unruling too her...I have the same issue with pain, when the wind blows and raining etc..Does anyone else have similiar stories..If so you can e-mail @ mrarick12@gmail.com..
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I have been misdiognosed 18 years with Trigeminal neuralgia. Since three years I am diagnosed with migraine.
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My heart breaks for my sister, Cathi and these people who all share the same stories of the terrible pain...I pray that research continues and everyone who suffers is helped....
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 It's really really bad for her alot of days...she is a real trooper though...but it has really affected her life so much! Thanks for your concern, it really means alot to me 😀
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 Has She tried botox injections? I've heard that is working for some people.
franniep1126 Member
I went to the doctor for migraines and told him about the stabbing pain, only lasts for a few seconds, above my left ear. After an MRI as well as medication for migraines I was diagnosed with trigeminal neuralgia. It comes and goes and is just above my left ear. I thought I was having a stroke.
carolinagirl Member
I have had headaches for all of my life, diagnosed with chronic migraines 20 years ago. After fighting a sinus infection for 2 months, a sinus X-ray and Ct scan my family dr referred to an ent. The ent thinks I have TN and has referred to me to a neurologist. I have no insurance and this is quite costly. I'm going to talk to dr of 22 years tomorrow about all of these results and possibilities. I got a daith piercing that stopped debilitated migraines on the left side, and now I have extremely painful facial pain that is just as bad.
Alene L. Brennan, RYT
Thanks for sharing such an informative article about trigeminal neuralgia. I feel like this topic is not talked about enough in the migraine community. It's not a commonly known symptom. That sad, one that that can be helpful in managing the pain is cranial sacral therapy. I wish I could adequately explain what it is or what it does, but it's an option to consider if you were interested. - Alene, moderator

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