New Delhi: Behind Salman Khan’s smile was a pain so intense that even eating an omelette felt like torture.
In a rare and emotional revelation, Bollywood superstar Salman Khan opened up about his seven-and-a-half-year battle with trigeminal neuralgia—a condition so painful, it’s often called the “suicidal disease”. Known for his larger-than-life roles and indomitable screen presence, few imagined that off-screen, he was enduring sharp, electric shock-like jolts of facial pain every few minutes.
“You wouldn’t wish this pain on your worst enemy,” Khan shared. “It used to hit me every four or five minutes. Just having breakfast took over an hour. For an omelette, I had to force myself—because even chewing was unbearable.”
Trigeminal neuralgia (TN) is a chronic nerve disorder that affects the trigeminal nerve, which carries sensation from the face to the brain. When this nerve becomes compressed—most often by a nearby blood vessel—it misfires, sending sudden, stabbing, or burning pain across the face. The pain usually comes in short bursts, lasting just seconds or minutes, but can strike dozens or even hundreds of times a day.
“Gamma Knife radiosurgery finally solved it for me,” Khan said, “but the memory of that pain never goes away.”
For many patients, even the simplest actions like talking, eating, brushing teeth, or feeling a gust of wind can trigger an attack. The unpredictable nature of TN leaves people living in constant fear of the next jolt.
Trigeminal neuralgia affects approximately four to 13 people per 1,00,000 each year, with women more commonly affected than men. The female-to-male ratio ranges from 1.5:1 to 1.7:1. While the condition typically appears after the age of 50, it can occasionally occur earlier, in the second or third decade of life.
Also read: Aryan Khan brings back the bad days of underworld-Bollywood nexus
Cause, diagnosis, and journey to relief
The most common cause of trigeminal neuralgia is a blood vessel pressing against the nerve near the base of the brain. This pressure erodes the myelin sheath, the nerve’s protective coating, leaving it hypersensitive. Less commonly, tumors, multiple sclerosis, or facial injuries may trigger the condition.
“Trigeminal neuralgia can deeply affect individuals and their families, disrupt daily routines, and diminish quality of life,” said Dr. Gurneet Singh Sawhney, a Mumbai-based neurosurgeon.
Diagnosing TN isn’t always straightforward. Its symptoms can resemble dental issues or migraines, often leading to delays in treatment. A thorough medical history and attention to classic pain patterns–brief, shock-like attacks on one side of the face–are key. MRI scans are essential to confirm nerve compression or rule out other underlying causes.
Once diagnosed, most patients begin with medication. The first choice is often carbamazepine, an anti-seizure drug that quiets overactive nerve signals. It’s effective in about 90 per cent of cases, though side effects like dizziness or nausea can be problematic. Oxcarbazepine is a gentler alternative, while other options include gabapentin, baclofen, lamotrigine, and amitriptyline. Opioids, notably, are rarely effective.
When medications fail or aren’t well tolerated, botulinum toxin (Botox) injections may offer temporary relief.
“For patients who don’t respond to drugs, surgery, especially microvascular decompression or Gamma Knife radiosurgery, can offer lasting relief,” says Dr. Michael Lim, Chair of Neurosurgery at Stanford Medicine.
The most common surgical option is microvascular decompression, where the surgeon gently moves the compressing blood vessel and places a soft cushion between it and the nerve. Other procedures include: Radiofrequency ablation (uses heat to destroy pain-causing nerve fibers) and Gamma Knife radiosurgery (a non-invasive, focused radiation procedure with no incisions)
These surgeries are often effective, but carry potential side effects, including numbness, facial weakness, or recurrence of pain over time.
(Edited by Ratan Priya)