Cranial neuralgia (pain associated with cranial nerves) can have a variety of causes, though they may not be identifiable. In some cases, the cranial nerves become damaged due to nerve compression. The nerves can become compressed or pinched by nearby structures, such as blood vessels or tumors. They can also be damaged by toxic chemicals, medications or physical trauma (including surgery), which can lead to cranial neuralgia. In some cases, the cause of a patient’s cranial neuralgia cannot be determined.

Certain conditions or infections can also cause cranial neuralgia. Diabetes damages the blood vessels that supply nerves, which can cause nerve malfunction and nerve loss. Other kidney and blood disorders (e.g., porphyria) allow toxins to accumulate in the blood, which can lead to neuralgia.

Other conditions that may also be related to cranial neuralgia include multiple sclerosis, arthritis, syphilis and Lyme disease. Herpes zoster oticus and postherpetic neuralgia may also result from nerve damage caused by the virus responsible for chickenpox and shingles.