Trigeminal neuralgia is characterized by excruciating paroxysms of pain in the lips, gums, cheek, or chin and, very rarely, in the distribution of the ophthalmic division of the fifth nerve. The pain seldom lasts more than a few seconds or a minute or two but maybe so intense the patient winces. The paroxysm, experienced as single jabs or clusters, tend to recur frequently, both day and night, for several weeks at a time. They may occur spontaneously or with movements of affected areas evoked by speaking, chewing, or smiling. Another characteristic feature is the presence of trigger zones, typically on the face, lips, or tongue, that provoke attacks; patients may report that tactile stimuli-e.g. washing the face, brushing the teeth, or exposure to a draft of air- generate excruciating pain.
Compression or other pathology in the fifth cranial nerve leads to demyelization of large myelinated fibers that do not themselves carry pain sensation but become hyperexcitable and electrically couples with smaller unmyelinated or poorly myelinated pain fibers in close proximity; this may explain why tactile stimuli, conveyed via the large myelinated fibers, can stimulate paroxysms of pain.
Commonly used homeopathic medicines for trigeminal neuralgia are Rhus Tox, Colocynth, kali. Carb, Phosphorus, Nux Vomica and Passiflora.