Trigeminal Neuralgia

Trigeminal neuralgia is one of the most severe forms of pain in the human experience. It is a chronic neuropathic disease characterized by recurrent attacks of lancinating facial pain occurring in the dermatomal distribution of the fifth cranial nerve. In most cases, the disorder affects only one side of the face. Trigeminal neuralgia is usually caused by compression from an intracranial artery (classical type). The secondary forms can be provoked by a neurological disease. There is no diagnostic test for a definite diagnosis of trigeminal neuralgia. Although the diagnosis is essentially clinical, neuroimaging plays a paramount role in knowing the etiology (secondary forms) and for identifying the surgical indications for decompression. Pharmacotherapy remains the first line of treatment. If acute pain persists despite drug therapy, surgical microvascular decompression or neuroablative treatments can be considered. Despite therapy, this disease continues to challenge health care providers due to its impact on patient’s psychological states. Patients must be enrolled in programs that can provide multi-professional support. This chapter aims to address multiple aspects of the disease including the extend of the problem, etiology, mechanisms, clinical features, and diagnosis. Furthermore, it reviews the current treatments and their implications for the patient’s prognosis.