Table 19 Clinical characteristics in trigeminal neuralgia

• Trigeminal neuralgia (TN) is a unilateral disorder of short-lasting stabbing pain paroxysms.

• The painful area typically involves the 2nd and/or 3rd trigeminal branch.

• The mean age of onset is 52 years, but the range of onset is wide (8–90 years).

• Pain attacks are evoked by light sensory stimuli such as chewing, touching the face, talking, tooth brushing, shaving and cold wind. There can also be spontaneous pain.

• Trigger zones are often located around the nasal wing and the lateral part of the upper and lower lip.

• Natural history of TN is unpredictable. There may be severe exacerbations of pain and there may be periods of complete pain remission lasting for weeks and months – in some cases even years.

• Symptomatic TN is caused by a brainstem plaque from multiple sclerosis or by a space-occupying lesion in the cerebellopontine angle cistern. At clinical presentation, it can be indistinguishable from primary TN.