Trigeminal neuralgia is a unilateral disorder affecting the face, with lancinating (sharp, like an electric shock) pain in one or more of the divisions of the trigeminal nerve. It can be diagnosed when certain clinical features are present.


Diagnostic features:

(1) paroxysmal attacks of facial or frontal pain, lasting from a few seconds to 2 minutes.

(2) 4 or 5 of the following:

(2a) distribution along one or more divisions of the trigeminal nerve

(2b) the pain is described as sudden, intense, sharp, superficial, stabbing or burning

(2c) the pain intensity is severe

(2d) between paroxysms the patient is asymptomatic

(2e) may be precipitated at a trigger areas or by eating, talking, washing the face or cleaning the teeth

(3) no neurological defect

(4) attacks are stereotypic for the individual patient

(5) other causes of pain have been excluded (by history, physical examination, special studies)



• While occasionally bilateral, the pain does not cross to the opposite side.

• The second and third divisions of the trigeminal nerve are more commonly affected, resulting in cheek or chin pain.

• Tic douloureux occurs when there is an associated muscle spasm on the same side.


Symptomatic trigeminal neuralgia secondary to a causative lesion can have aching pain that persists between paroxysms or a sensory impairment in the distribution of one or more branches of the trigeminal nerve.


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