Trigeminal Neuralgia 

Trigeminal neuralgia also known as ‘tic douloureux’ or ‘Fothergill’s disease’, is is the most common of the cranial neuralgias. The International Association for the Study of Pain (IASP) defined trigeminal neuralgia as “Sudden usually unilateral severe brief stabbing recurrent pain in the distribution of one or more branches of the 5th cranial nerve.”
The fifth cranial nerve or the Trigeminal nerve has 3 branches, the ophthalmic, maxillary, and mandibular nerves. It usually affects adults over 50 years of age. The International Classification of Headache Disorders (ICHD-3) describes 3 variants of trigeminal neuralgia that may only be diagnosed following imaging: Classical trigeminal neuralgia (CTN), Secondary, and Idiopathic. The diagnosis of TN is based on the history of shooting, electric shock-like pain along a branch of the trigeminal nerve, the presence of trigger zones and refractory periods. Carbamazepine is the most commonly prescribed drug and is an effective therapy for greater than 85% of newly diagnosed cases of TN. The most extensively studied and most successful surgical procedure is microvascular decompression of the nerve root at the brainstem where the artery is separated from the nerve root. Over 70% of patients experience long-term relief of symptoms.