Trigeminal Neuralgia in Emergency Medicine Workup

Updated: Nov 22, 2016
  • Author: J Stephen Huff, MD, FACEP; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Workup

Imaging Studies

Patients with characteristic history and normal neurologic examination may be treated without further workup. Some physicians recommend elective MRI for all patients to exclude an uncommon mass lesion or aberrant vessel compressing the nerve roots.

Perform an MRI if atypical features are present.

Consider MRI to identify patients with structural causes.

In a published practice parameter, the American Academy of Neurology stated that because of inconsistency of studies, there was insufficient evidence to support or refute the usefulness of MRI or a specific MRI technique to identify vascular anomalies. The recommendation was that, for patients with trigeminal neuralgia, routine imaging may be considered to identify symptomatic trigeminal neuralgia, and this was graded as a Level C or possibly effective action. [4]