Can long term stress and anxiety cause trigeminal neuralgia?

Not likely: The causes of trigeminal neuralgia include some compression of the nerve and some other possible causes. Stress and anxiety may certainly worsen the problem and bring it to attention, but they alone are not likely the underlying cause. We typically perform imaging to look for something that is pressing on the nerve, so to speak. I recommend the American Headache Society website for more into.

Dr Alves agreed

Yes : One of the most common symptoms of stress is teeth grinding, either in u'r sleep or while awake. This affects your "jaw joint"=TemparoMandibularJoint. The Trigeminal Nerve sits very close to this joint.