Epidemiology

• Peak incidence: 60–70 years

Classification

• Classical trigeminal neuralgia (CTN): caused by neurovascular compression, most often by an aberrant loop of a neighboring artery (usually the superior cerebellar artery)
• Secondary trigeminal neuralgia (STN): caused by a major underlying neurological disease, most frequently multiple sclerosis, a tumor at the cerebellopontine angle, or arteriovenous malformation.
• Idiopathic trigeminal neuralgia (ITN): no identifiable cause (unremarkable findings on MRI and electrophysiological tests)

Clinical features

• Unilateral facial pain: paroxysmal, severe shooting or stabbing (like an electric shock), followed by a burning ache
  • Lasts several seconds (in rare cases, several minutes) and may occur up to 100 times per day
  • Typically shoots from mouth to the angle of the jaw on the affected side
  • Occurs either at rest or is triggered by movements such as chewing, talking, or touch (e.g., brushing teeth, washing face); becomes worse with stimulation

Diagnostics

Treatment

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