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Trigeminal Neuralgia

Daniel R. Matta, DFPHM, FAAFP, MD and William B Bradley, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Trigeminal neuralgia (TN) is a painful disorder of the sensory nucleus of the fifth cranial (trigeminal) nerve that commonly produces episodic, paroxysmal, severe, lancinating facial...

DIAGNOSIS

HISTORY

Paroxysms of pain in the distribution of the trigeminal nerve, which include the ophthalmologic (V1), maxillary (V2), and mandibular (V3) branches. Patients typically experience unila...

TREATMENT

GENERAL MEASURES

  • Avoid stimulation (e.g., air, heat, cold) of trigger zones, including lips, cheeks, and gums.

  • Medication treatment is first line.

  • Invasive procedures are reserved for patients ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Follow up, every 3-6 months in initial few years, to monitor symptoms and treatment efficacy.

  • Patients with TN, especially those whose symptoms are proving refract...

REFERENCES

1
Lambru G, Zakrzewska J, Matharu M. Trigeminal neuralgia: a practical guide. Pract Neurol. 2021;21(5):392-402. doi: 10.1136/practneurol-2020-002782. PMID: 34108244.
2
Allam AK, Sharma H, Lark...

CODES

ICD10

  • B02.22 Postherpetic trigeminal neuralgia

  • G50.0 Trigeminal neuralgia

SNOMED

  • 12242071000119103 Left trigeminal neuralgia

  • 12242111000119105 Right trigeminal neuralgia

  • 230537000 Idiopathic trigemina...

CLINICAL PEARLS

  • Patients with TN typically have a normal physical exam.

  • Imaging, ideally MRI, should be obtained to rule-out secondary causes in newly presenting patients with clinical suspicion of TN...

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