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General Medical Questions
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Q: I experience electrical shocks on the left side of my face. The shocks come on about once or twice a month. My doctor does not know what this is. Do you have any idea what could cause such a symptom?
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The Trusted Source
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Robert H. Shmerling, M.D.

Robert H. Shmerling, M.D., is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.

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January 06, 2010
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A:

Discomfort that feels like an “electric shock” suggests a nerve problem. Perhaps the most common example is sciatica. The sciatic nerve is compressed or irritated. This causes a shooting pain down the back of the leg.

The sensation of an electric shock along the side of the face strongly suggests a condition called trigeminal neuralgia. This is nerve pain (neuralgia) from the trigeminal nerve.

Branches of the trigeminal nerve travel from just in front of the ear to the forehead, temple, cheek and chin. When this nerve sends pain signals to the brain, it causes an electrical shock-like sensation along its course. Sometimes, the cause of trigeminal neuralgia can be pinpointed. Recognized causes include:

  • compression by an abnormal blood vessel
  • multiple sclerosis
  • a tumor near the trigeminal nerve (this is rare)

In many cases, no cause can be found. It’s as if the nerve is simply “misfiring,” sending pain signals for no apparent reason.

Treatment of trigeminal neuralgia includes:

  • pain relievers such as Tylenol or ibuprofen (if symptoms are mild)
  • drugs to treat nerve pain, such as gabapentin (Neurontin) or amitriptyline (Elavil)
  • anti-seizure drugs, including carbamazepine, phenytoin or oxcarbazepine
  • injections of alcohol, novocaine-type drugs, cortisone (or combinations of these)
  • surgery to relieve pressure on the trigeminal nerve or to interrupt its pain signals

While your symptoms suggest trigeminal neuralgia, there are other possible causes of facial pain, such as dental problems and sinus inflammation. So, talk to your doctor about your symptoms. Together, you can decide on an evaluation and treatment plan that make sense for you.

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