It is not uncommon for the pain to affect more than one division of the nerve. It is rare for TN to simultaneously affect both sides of the face. One exception is patients with multiple sclerosis who occasionally develop bilateral 1st division pain. The episodes of pain may come on spontaneously but can be triggered by various actions such as talking, chewing, washing the face, brushing the teeth, etc. The episodes of pain usually last from a few seconds to several minutes and then subside completely.
Most patients are completely free of pain between each episode.
At the onset of the illness, the pain may occur infrequently, but as time passes, some patients may begin to experience many separate episodes of pain each day. Most patients do not describe any other neurological symptoms that are associated with the pain. The neurological examination is completely normal.