Which clinical history findings are characteristic of trigeminal neuralgia (TN)?

Updated: Oct 23, 2019
  • Author: Mityanand Ramnarine, MD, FACEP; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Answer

History is the most important factor in the diagnosis of typical or classical trigeminal neuralgia (TN). Symptomatic trigeminal neuralgia secondary to intracranial processes may have a different history.

Nature of pain

Pain is brief and paroxysmal, but it may occur in volleys of multiple attacks.

Pain is stabbing or shocklike and is typically severe.

Distribution of pain

One or more branches of the trigeminal nerve (usually maxillary or mandibular in unilateral distribution) are involved.

Pain is unilateral in classical trigeminal neuralgia. Bilateral pain suggests symptomatic trigeminal neuralgia. [3]

Duration of pain is typically from a few seconds to 1-2 minutes. Pain may occur several times a day; patients typically experience no pain between episodes.

Trigger points

Various triggers may commonly precipitate a pain attack. Light touch or vibration is the most provocative.

Activities such as shaving, face washing, or chewing often trigger an episode.

Stimuli as mild as a light breeze may provoke pain in some patients.

Pain provokes brief muscle spasm of the facial muscles, thus producing the tic.


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