Trigeminal Neuralgia: A Clinical Review for the General Physician

Abstract

General practitioners (GPs) are often the first clinicians to encounter patients with trigeminal neuralgia (TN). Given the gravity of the debilitating pain associated with TN, it is important for these clinicians to learn how to accurately diagnose and manage this illness. The objective of this article is to provide an up-to-date literature review regarding the presentation, classification, diagnosis, and the treatment of TN. This article also focuses on the long-term management of these patients under the care of GPs. GPs play an important role in the management of patients with TN by following the evidence-based management guidelines. The most important aspects of the management of TN are discussed in this review article.

Clinical Characteristics and Associated factors of Trigeminal Neuralgia in Addis Ababa, Ethiopia: Experience from Addis Ababa, Ethiopia

“…This nding is similar to report from Thailand (Jainkittivong et al 2012) where 40.5% reported a history of tooth extraction. The mandibular nerve was the commonest branch to be affected, followed by a mixed mandibular + maxillary branch, while the ophthalmic branch was not involved in any of our study participants, which is in line with previous reports (Maarbjerg et al, 2014, Majeed et al, 2018.…”

Trigeminal Neuralgia: Etiology, Diagnosis, and Treatment

“…Lastly, the final classification of TN is idiopathic which occurs without an apparent cause while showing the same or similar symptoms to classical TN. In this case, both radiographical imaging and electrophysiological tests show no signs of significant abnormalities [9].…”

“…Studies have found a slight preference for rightsided vs left-sided facial pain; rarely is TN found to be bilateral (approximately 3-5% of cases) [9]. The second (V2) and third (V3) branches of the trigeminal nerve are most often implicated [9]. Atypical features, as previously described, might be present in patients with symptomatic TN due to the effects of the underlying pathology [15].…”

“…In classical TN, the discomfort may be triggered by stimuli that are not usually painful such as mastication, light touch, tooth brushing, eating, talking, and exposure to a cold gentle breeze to the face [34]. Trigger zones can be found in over 90% of patients, and touch or vibration are the most common stimuli evoking the sensation of pain [9]. Some patients describe facial tingling or numbness that precedes the onset of pain [28].…”

“…The pain associated with TN may be localized to a specific area or it may be widespread, and the range in severity of symptoms can be so great that some patients might experience only mild pain, while for others, it can be so severe that it can impact the patient's ability to eat or maintain proper oral hygiene. Studies have found a slight preference for rightsided vs left-sided facial pain; rarely is TN found to be bilateral (approximately 3-5% of cases) [9]. The second (V2) and third (V3) branches of the trigeminal nerve are most often implicated [9].…”