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Trigeminal Neuralgia

Daniel R. Matta, MD and Sandya Jiandani Reviewed 06/2022
 


BASICS

DESCRIPTION

  • A painful disorder of the sensory nucleus of the fifth cranial (trigeminal) nerve that produces episodic, paroxysmal, severe, lancinating facial pain lasting seconds to minutes

  • Often ...

DIAGNOSIS

HISTORY

Paroxysms of pain in the distribution of the trigeminal nerve. The trigeminal nerve has three branches and innervates the entire side of the face. They are known as ophthalmologic (V1...

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. 

Patient Monitoring

REFERENCES

1
Wiffen  PJ, Derry  S, Moore  RA, et al. Carbamazepine for chronic neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev.  2014;(4):CD005451. ...

ADDITIONAL READING

  • Bendtsen L, Zakrzewska J, Heinskou T et al. Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia. The Lancet Neurology...

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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