Overview
What is trigeminal neuralgia (TN)?
What are the signs and symptoms of trigeminal neuralgia (TN)?
How is trigeminal neuralgia (TN) diagnosed?
How is trigeminal neuralgia (TN) treated?
How is trigeminal neuralgia (TN) characterized?
When was trigeminal neuralgia (TN) first described?
What is the cranial anatomy relevant to trigeminal neuralgia (TN)?
What is the pathophysiology of trigeminal neuralgia (TN)?
What causes trigeminal neuralgia (TN)?
What is the prevalence of trigeminal neuralgia (TN)?
Which patient groups have the highest prevalence of trigeminal neuralgia (TN)?
What is the prognosis of trigeminal neuralgia (TN)?
What are the possible complications of trigeminal neuralgia (TN)?
What is included in patient education about trigeminal neuralgia (TN)?
Where are patient education resources about trigeminal neuralgia (TN) found?
Presentation
Which clinical history findings are characteristic of trigeminal neuralgia (TN)?
How is pain localized in trigeminal neuralgia (TN)?
How is the pain of trigeminal neuralgia (TN) characterized?
How frequent are attacks of trigeminal neuralgia (TN)?
What may trigger an attack of trigeminal neuralgia (TN)?
Which physical findings are characteristic of trigeminal neuralgia (TN)?
How is trigeminal neuralgia (TN) classified?
What are the IHS diagnostic criteria for trigeminal neuralgia (TN)?
What is the Eller classification scheme for trigeminal neuralgia (TN)?
DDX
How is the differential diagnoses of trigeminal neuralgia (TN) narrowed?
How is trigeminal neuralgia (TN) differentiated from migraine and cluster headaches?
How is trigeminal neuralgia (TN) differentiated from atypical face pain?
How is trigeminal neuralgia (TN) differentiated from paroxysmal hemicrania syndromes?
How is secondary trigeminal neuralgia (TN) differentiated from idiopathic trigeminal neuralgia (TN)?
How is trigeminal neuropathy differentiated from idiopathic trigeminal neuralgia (TN)?
How is herpetic and postherpetic neuralgia (PHN)differentiated from trigeminal neuralgia (TN)?
What are the differential diagnoses for Trigeminal Neuralgia?
Workup
What is the role of lab testing in the workup of trigeminal neuralgia (TN)?
What is the role of MRI in the workup of trigeminal neuralgia (TN)?
What is the role of MRA in the workup of trigeminal neuralgia (TN)?
What is the role of CT scanning and CT angiography in the workup of trigeminal neuralgia (TN)?
What is the role of clinical neurophysiologic testing in the workup of trigeminal neuralgia (TN)?
Which histologic findings are characteristics of trigeminal neuralgia (TN)?
Treatment
What is the approach to treatment of trigeminal neuralgia (TN)?
How is trigeminal neuralgia (TN) treated initially?
What are the treatment options for trigeminal neuralgia (TN)?
Which adjunct therapies are used in the treatment of trigeminal neuralgia (TN)?
How is depression treated in patients with trigeminal neuralgia (TN)?
What is the role of antiepileptic drugs in the treatment of trigeminal neuralgia (TN)?
What is the cost of medications for the treatment of trigeminal neuralgia (TN)?
What is the efficacy of antiepileptic drugs for the treatment of trigeminal neuralgia (TN)?
How are antiepileptic drugs dosed for the treatment of trigeminal neuralgia (TN)?
What are the potential risks of antiepileptic drugs for the treatment of trigeminal neuralgia (TN)?
What are the first- and second-line medications for the treatment of trigeminal neuralgia (TN)?
What is the role of carbamazepine in the treatment of trigeminal neuralgia (TN)?
What is the role of oxcarbazepine (Trileptal) in the treatment of trigeminal neuralgia (TN)?
What is the role of gabapentin in the treatment of trigeminal neuralgia (TN)?
What is the role of lamotrigine (Lamictal) in the treatment of trigeminal neuralgia (TN)?
What is the role of phenytoin in the treatment of trigeminal neuralgia (TN)?
What is the efficacy of non-antiepileptic drugs in the treatment of trigeminal neuralgia (TN)?
What is the role of baclofen in the treatment of trigeminal neuralgia (TN)?
What is the role of dextromethorphan in the treatment of trigeminal neuralgia (TN)?
What is the role of botulinum toxin in the treatment of trigeminal neuralgia (TN)?
What is the role of misoprostol in the treatment of trigeminal neuralgia (TN)?
What is the role of surgery in the treatment of trigeminal neuralgia (TN)?
What types of surgical interventions are used in the treatment of trigeminal neuralgia (TN)?
What is the cost of surgery for trigeminal neuralgia (TN)?
What is the timing for surgical intervention to treat trigeminal neuralgia (TN)?
What are the risks of surgery for trigeminal neuralgia (TN)?
What is the role of microvascular decompression (MVD) in the treatment of trigeminal neuralgia (TN)?
What is the role of percutaneous procedures in the treatment of trigeminal neuralgia (TN)?
How is PRTG performed for the treatment of trigeminal neuralgia (TN)?
How is PRGR performed for the treatment of trigeminal neuralgia (TN)?
How is PBM performed for the treatment of trigeminal neuralgia (TN)?
What is the role of gamma knife surgery in the treatment of trigeminal neuralgia (TN)?
Which specialist consultations are beneficial to patients with trigeminal neuralgia (TN)?
What is included in the long-term monitoring of trigeminal neuralgia (TN)?
Guidelines
What are the EAN guidelines on trigeminal neuralgia (TN) treatment?
Medications
What is the role of medications in the treatment of trigeminal neuralgia (TN)?
Which medications in the drug class Toxins are used in the treatment of Trigeminal Neuralgia?
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Illustration depicting the trigeminal nerve with its 3 main branches
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Microscopic demonstration of demyelination in primary trigeminal neuralgia. A tortuous axon is surrounded by abnormally discontinuous myelin. (Electron microscope; 3300×).
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Magnetic resonance image (MRI) with high resolution on the pons demonstrating the trigeminal nerve root. In this case, the patient with trigeminal neuralgia has undergone gamma-knife therapy, and the left-sided treated nerve (arrow) is enhanced by gadolinium.
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Microvascular decompression (Jannetta procedure) used to treat trigeminal neuralgia. The anteroinferior cerebellar artery and the trigeminal nerve are in direct contact. Courtesy of PT Dang, CH Luxembourg
Tables
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- Overview
- Presentation
- DDx
- Workup
- Treatment
- Approach Considerations
- Overview of Antiepileptic Drugs
- Carbamazepine Therapy
- Gabapentin Therapy
- Lamotrigine Therapy
- Phenytoin Therapy
- Non-antiepileptic Drug Therapy
- Surgical Considerations
- Microvascular Decompression
- Percutaneous Procedures
- Gamma Knife Surgery
- Consultations
- Long-Term Monitoring
- Show All
- Guidelines
- Medication
- Questions & Answers
- Media Gallery
- Tables
- References