Introduction to Trigeminal Neuralgia

  • Ritesh Lamsal
  • Girija Prasad Rath


Trigeminal neuralgia (TGN) refers to recurrent lancinating pain that occurs in the distribution of one or more branches of the fifth cranial nerve. It is one of the commonest types of craniofacial pain disorders. The pain perception is typically unilateral, abrupt in onset, brief in duration, and usually starts after trivial stimuli. With progression of TGN, the interval between bouts of pain shorten. In advanced cases, patients may report of pain at most times of the day and pain relief with oral drugs may be very poor. The pain is most commonly felt in the distribution of maxillary (V2) or mandibular (V3) divisions of the trigeminal nerve [1]. Less common presentations include combinations of ophthalmic (V1) and V2, V2 and V3, or all three divisions [1]. Solitary involvement of V1 division is very rare.


  1. 1.
    Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition. Cephalalgia. 2018;38:1–211.Google Scholar
  2. 2.
    Manzoni GC, Torelli P. Epidemiology of typical and atypical craniofacial neuralgias. Neurol Sci. 2005;26(Suppl 2):s65–7.CrossRefGoogle Scholar
  3. 3.
    Koopman JS, Dieleman JP, Huygen FJ, de Mos M, Martin CG, Sturkenboom MC. Incidence of facial pain in the general population. Pain. 2009;147:122–7.CrossRefGoogle Scholar
  4. 4.
    Hall GC, Carroll D, Parry D, McQuay HJ. Epidemiology and treatment of neuropathic pain: the UK primary care perspective. Pain. 2006;122:156–62.CrossRefGoogle Scholar
  5. 5.
    Hooge JP, Redekop WK. Trigeminal neuralgia in multiple sclerosis. Neurology. 1995;45:1294–6.CrossRefGoogle Scholar
  6. 6.
    De Toledo IP, Conti Reus J, Fernandes M, Porporatti AL, Peres MA, Takaschima A, et al. Prevalence of trigeminal neuralgia: a systematic review. J Am Dent Assoc. 2016;147:570–6.e2.CrossRefGoogle Scholar
  7. 7.
    Katusic S, Beard CM, Bergstralh E, Kurland LT. Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945-1984. Ann Neurol. 1990;27:89–95.CrossRefGoogle Scholar
  8. 8.
    Maarbjerg S, Gozalov A, Olesen J, Bendtsen L. Trigeminal neuralgia – a prospective systematic study of clinical characteristics in 158 patients. Headache. 2014;54:1574–82.CrossRefGoogle Scholar
  9. 9.
    Reddy GD, Viswanathan A. Trigeminal and glossopharyngeal neuralgia. Neurol Clin. 2014;32:539–52.CrossRefGoogle Scholar
  10. 10.
    Pollack IF, Jannetta PJ, Bissonette DJ. Bilateral trigeminal neuralgia: a 14-year experience with microvascular decompression. J Neurosurg. 1988;68:559–65.CrossRefGoogle Scholar
  11. 11.
    Pearce JM. Trigeminal neuralgia (Fothergill’s disease) in the 17th and 18th centuries. J Neurol Neurosurg Psychiatry. 2003;74:1688.CrossRefGoogle Scholar
  12. 12.
    Patel SK, Liu JK. Overview and history of trigeminal neuralgia. Neurosurg Clin N Am. 2016;3:265–76.CrossRefGoogle Scholar
  13. 13.
    Cole CD, Liu JK, Apfelbaum RI. Historical perspectives on the diagnosis and treatment of trigeminal neuralgia. Neurosurg Focus. 2005;18:E4.CrossRefGoogle Scholar
  14. 14.
    Fothergill J. Of a painful affection of the face. Medical observations and inquiries. 1773;5:129–42.Google Scholar
  15. 15.
    Bergouignan M. Cures heureuses de neurologies essentielles par le dephenyl hydantoinate de sounde. Rev Laryngol Otol Rhinol. 1942;63:34–41.Google Scholar
  16. 16.
    Blom S. Trigeminal neuralgia: its treatment with a new anticonvulsant drug (G-32883). Lancet. 1962;1:839–40.CrossRefGoogle Scholar
  17. 17.
    Stookey B, Ransohoff J. Trigeminal neuralgia: its history and treatment. In: Thomas CP, editor. Principles of neurological surgery. Springfield, IL: Charles C. Thomas; 1959.Google Scholar
  18. 18.
    Lunsford LD, Bennett MH. Percutaneous retrogasserian glycerol rhizotomy for tic douloureux: part 1. Technique and results in 112 patients. Neurosurgery. 1984;14:424–30.CrossRefGoogle Scholar
  19. 19.
    Wilkins R. Trigeminal neuralgia: historical overview, with emphasis on surgical treatment. In: Burchiel K, editor. Surgical management of pain. New York: Thieme; 2002. p. 288–301.Google Scholar
  20. 20.
    Kirschner M. Zur elektrochirurgie. Langenbecks Arch Klin Chir. 1931;167:761–8.Google Scholar
  21. 21.
    Sweet WH, Wepsic JG. Controlled thermocoagulation of trigeminal ganglion and rootlets for differential destruction of pain fibers. 1. Trigeminal neuralgia. J Neurosurg. 1974;40:143–56.CrossRefGoogle Scholar
  22. 22.
    Nugent GR. Radiofrequency treatment of trigeminal neuralgia using a cordotomy-type electrode. A method. Neurosurg Clin N Am. 1997;8:41–52.CrossRefGoogle Scholar
  23. 23.
    Taha JM, Tew JM Jr. Treatment of trigeminal neuralgia by percutaneous radiofrequency rhizotomy. Neurosurg Clin N Am. 1997;8:31–9.CrossRefGoogle Scholar
  24. 24.
    Abdennebi B, Bouatta F, Chitti M, Bougatene B. Percutaneous balloon compression of the Gasserian ganglion in trigeminal neuralgia. Long-term results in 150 cases. Acta Neurochir. 1995;136:72–4.CrossRefGoogle Scholar
  25. 25.
    Mullan S, Lichtor T. Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia. J Neurosurg. 1983;59:1007–12.CrossRefGoogle Scholar
  26. 26.
    Brown JA, Chittum CJ, Sabol D, Gouda JJ. Percutaneous balloon compression of the trigeminal nerve for treatment of trigeminal neuralgia. Neurosurg Focus. 1996;1:E10.CrossRefGoogle Scholar
  27. 27.
    Rand RW, Jacques DB, Melbye RW, Copcutt BG, Levenick MN, Fisher MR. Leksell Gamma Knife treatment of tic douloureux. Stereotact Funct Neurosurg. 1993;61(Suppl 1):93–102.CrossRefGoogle Scholar
  28. 28.
    Barker FG 2nd, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD. The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med. 1996;334:1077–83.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Ritesh Lamsal
    • 1
  • Girija Prasad Rath
    • 1
  1. 1.Department of Neuroanaesthesiology and Critical Care Neurosciences CentreAll India Institute of Medical SciencesNew DelhiIndia

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