Trigeminal Neuralgia: Historical Notes and Current Concepts

  title={Trigeminal Neuralgia: Historical Notes and Current Concepts},
  author={Sashank Prasad and Steven L. Galetta},
  journal={The Neurologist},
Background:Trigeminal neuralgia is a syndrome of paroxysmal excruciating, lancinating unilateral facial pain. Review Summary:There are several clinical features that are characteristic of trigeminal neuralgia, but there may be red flags that should suggest alternative diagnoses. There is convincing evidence that the idiopathic form develops from focal demyelination at the trigeminal root entry zone with subsequent ephaptic cross-talk between axons. Vascular compression of the nerve root causes… 

Trigeminal Neuralgia: Current Concepts in the Medical Management

Although various drugs have been used in the management of TN such as baclofen, gabapentin, phenytoin sodium, carbamazepine remains the gold standard drug of choice.

Trigeminal Nerve Blocks and Neurolysis

The trigeminal nerve blocks and neurolysis are indicated in patients who have failed to respond to conservative treatments with medications and there are three procedures (radiofrequency thermocoagulation, balloon compression, and glycerolysis) that target the Gasserian ganglion and several procedures thattarget the branches of the trigemINAL nerve.

Case series: non vascular considerations in trigeminal neuralgia

A series of unusual lesions, all of which initially presented with neuralgic-like symptoms and were refractory to treatment are presented and the value of diagnostic imaging in trigeminal neuralgia patient is emphasised.

Trigeminal Neuralgia- Neuroanatomical Explanation and Case Report. -

In this case report, 49 year old lady with intense, sudden electric shock like pain on her chin and cheek is discussed, who had been diagnosed as trigeminal neuralgia and started with medical treatment.

A Typical Presentation of Trigeminal Neuralgia Induced by Intracranial Hypertension Mimicking Sinusitis

The case of a 56-years-old woman, who presented with trigeminal neuralgia mimicking chronic sinusitis is presented to avoid imprecise treatment at early stages and for a better prognosis.

The Molecular Basis and Pathophysiology of Trigeminal Neuralgia

The current article aims to review the latest findings on the pathophysiology of TN and cross-examining them with the current surgical and pharmacologic management for TN patients, to help scientists and clinicians to identify novel targets and improve treatments for this complex, debilitating disease.

Etiopathogenesis of Trigeminal Neuralgia

  • A. Bindra
  • Medicine
    Handbook of Trigeminal Neuralgia
  • 2019
The characteristic signs and symptoms, and response to distinctive set of therapeutic modalities helps not only in disease identification but also unveils the underlying pathogenetic mechanism.

Subdural hematoma presenting as trigeminal neuralgia: A case report

The clinical case of a patient describing symptoms appealing for the first branch of trigeminal neuralgia with little evolution is reported, but the final cause was actually a subdural hematoma.

Atypical Trigeminal Neuralgia Secondary to Meningioma

The magnetic resonance imaging study of brain revealed a large extra-axial mass involving right cerebellopontine angle region causing moderate pressure effect on trigeminal nerve and brain stem.


MVD is a safe and effective surgical option for treating patients with idiopathic TGN with better surgical outcome and fewer complications.



Trigeminal neuralgia: pathology and pathogenesis.

Clinical observations and electrophysiological studies support the concept that demyelination and ephaptic spread of excitation underlie most, if not all, of these conditions.

Operative Findings and Outcomes of Microvascular Decompression for Trigeminal Neuralgia in 35 Patients Affected by Multiple Sclerosis

Results of MVD in trigeminal neuralgia MS patients are much less satisfactory than in the idiopathic group, indicating that central mechanisms play a major role in pain genesis.

Pathological findings associated with trigeminal neuralgia caused by vascular compression.

Findings support the hypothesis that ephaptic transmission plays a role in the pathogenesis of trigeminal neuralgia related to vascular compression, which is associated with focal loss of myelin and close apposition of the demyelinated axons.

From paroxysmal to chronic pain in trigeminal neuralgia

An electrophysiologic analysis of trigeminal nociceptive pathways in patients with typical TN and those with persisting chronic pain in between paroxysms, using a novel, concentric stimulating electrode which has previously been shown to preferentially depolarize superficial nocICEptive A-delta fibers.

Gabapentin for idiopathic trigeminal neuralgia

The experience with two cases of trigeminal neuralgia treated with gabapentin after conventional treatment failed is reported, finding that these patients had been pain-free since a few days after their last clinic visit and had not experienced any side effects.

Trigeminal neuralgia.

Peripheral glycerol injections in the treatment of idiopathic trigeminal neuralgia: retrospective analysis of 157 cases.

  • E. ErdemA. Alkan
  • Medicine, Biology
    Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
  • 2001
Peripheral glycerol injection is a minimally invasive and useful technique to manage trigeminal neuralgia, with a high success rate and low incidence of morbidity.


The electrical potential changes in the human trigeminal system associated with the paroxysmal pain remain to be investigated and the effect of anti-epileptic drugs, such as hydantoin and lidocain, has been investigated.

Neurovascular compression in trigeminal neuralgia: a clinical and anatomical study.

A combined study of clinical and anatomical material employing standardized definitions of the neurovascular relationships in both groups confirms that vascular compression of the fifth cranial nerve is an anatomical abnormality specific to trigeminal neuralgia.

Defining the role for gabapentin in the treatment of trigeminal neuralgia: a retrospective study.

  • W. Cheshire
  • Medicine, Psychology
    The journal of pain : official journal of the American Pain Society
  • 2002
It is suggested that gabapentin can be effective as first or second line treatment of trigeminal neuralgia, even in cases resistant to traditional treatment modalities.