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The Connection Between Multiple Sclerosis and Trigeminal Neuralgia

The Connection Between MS and TN

There are certain neurological conditions that have very distinctive symptoms. For example, a stroke can be recognized by facial drooping, arm weakness, and speech difficulties, which spell out the acronym “FAST” (The “T” stands for timing is critical). Not every neurological condition has symptoms that fit neatly into acronyms, however. There is also the fact that some symptoms may not even be recognized immediately as being a symptom of a particular condition.

Such is the case with multiple sclerosis (MS) and trigeminal neuralgia. While they are two separate conditions, there is a connection between MS and trigeminal neuralgia that many people do not know about. In this blog post, we will explore the link between MS and trigeminal neuralgia, including some of the symptoms they can share.

What is Trigeminal Neuralgia?

diagram showing the trigeminal nerve

Trigeminal neuralgia (TN) is a condition in which patients experience brief, sometimes extremely painful electric shock-like facial pain. The most common areas for pain to occur are the cheek, forehead, and ear. Pain associated with TN feels like a shooting or jabbing achiness or burning.  These painful sensations can last for only a few seconds or go on for minutes. In the most severe cases, they can even last around an hour or longer.

TN is caused when the trigeminal nerve becomes irritated or compressed. This can happen for a variety of reasons, including:

  • A tumor or other mass that is pressing on the nerve
  • Dental problems, such as a cavities or wisdom teeth extractions
  • Injury or trauma to the face
  • Hypertension (high blood pressure)
  • Stroke

MS has also been said to be a potential cause of TN. On its own, TN tends to cause pain on only one side of the face. However, TN caused by MS can cause pain on both sides of the face.

What is MS?

MS is a common central nervous system (CNS) disease that causes loss of balance, visual problems, lack of coordination, tremors, dizziness and weakness (among other symptoms). The name is derived from the scars, or sclerae, that form on the white matter as a result of damage to myelin sheaths around nerve fibers in the brain and spinal cord. Eventually, these sclerae cause lasting lesions to form, which interferes with nerve signals.

Symptoms of MS vary in type and intensity, depending on the location and severity of brain lesions. Symptoms of MS can come and go, or they may be permanent. While there is a wide range of MS symptoms, here are some of the more commonly seen symptoms:

  • Numbness or tingling in the arms, legs, face, or extremities
  • Extreme fatigue
  • Blurred vision and eye pain
  • Speech difficulties
  • Memory loss
  • Depression
  • Acute or chronic pain

Numbness or tingling in the arms, legs, and face are one early sign of MS. However, many people may dismiss this symptom because it is mild and easy to ignore. It is also important to note that numbness and tingling can be caused by a variety of other conditions.

How are Multiple Sclerosis and Trigeminal Neuralgia Connected?

Research indicates that multiple sclerosis and trigeminal neuralgia are related. In fact, the National Multiple Sclerosis Society notes that half of people with MS experience chronic pain, including pain associated with TN. The American Association of Neurological Surgeons (AANS) adds to this by saying that MS is one cause of TN in cases where TN is not due to nerve compression.  For people with trigeminal neuralgia who also have multiple sclerosis, the condition is referred to as secondary trigeminal neuralgia.

healthy nerve vs nerve affected by demyelination

One hypothesis as to why these two conditions are closely related is that trigeminal neuralgia and multiple sclerosis both involve damage to myelin sheaths, which suggests that the two conditions share a common underlying mechanism. Both conditions affect the central nervous system: MS is a disease that damages myelin sheaths around nerve fibers, while trigeminal neuralgia is a condition that can be caused by myelin deterioration or lesions around the trigeminal nerve.

There are also other hypotheses as to how these two conditions are related. Some researchers believe that inflammation caused by MS may lead to the development of trigeminal neuralgia, while others suggest that the two conditions may be caused by a genetic link.

It is also important to note that although trigeminal neuralgia is one of the most common neurological complications in patients with multiple sclerosis, not all patients with multiple sclerosis experience trigeminal neuralgia. Similarly, not all people with the disorder will develop the disease.

In Conclusion

It is clear that there is a strong connection between multiple sclerosis and trigeminal neuralgia. The two conditions often occur together and patients with one disease are especially likely to develop the other. However, not everyone affected by one or the other will develop both conditions. Nevertheless, if you are experiencing pain in the face, it is important to be evaluated by a neurologist for both MS and trigeminal neuralgia.

Headshot of Premier Neurology & Wellness Center Practitioner Kashouty

Dr. Kashouty, a diplomate of the American Board of Psychiatry and Neurology (ABPN), practices general neurology with fellowship trained specialization in clinical neurophysiology. Dr. Kashouty finds the form and function of the nerves and muscles the most interesting part of neurology, which is what led him to specialize in neurophysiology with more emphasis on neuromuscular conditions. He treats all neurological diseases, but his main focus is to treat and manage headaches, movement disorders and neuromuscular diseases. 

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