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This condition affects the trigeminal nerve which is responsible for carrying sensation from the face to the brain. Most cases of trigeminal neuralgia are caused by a blood vessel (artery or vein) pressing on the trigeminal nerve as it exists the brain stem. This compression damages the protective coating around the nerve over time, interfering with its normal functioning and resulting in pain. Occasionally the condition may be caused by multiple sclerosis or a brain tumour.