Facial pain: trigeminal neuralgia

Abstract

Trigeminal neuralgia (TN) is a debilitating condition characterised by attacks of sharp, shooting, severe pain in the orofacial region. It can be triggered by activities of daily living such as eating, speaking, washing the face, shaving and brushing teeth. It therefore has a significant impact on a patient’s social interaction, mood and well-being. Other causes for facial pain need to be effectively excluded prior to establishing a diagnosis of TN. It is important to establish a diagnosis promptly. Often patients can see many practitioners including their general dental practitioner, GP and various secondary referral practitioners before a diagnosis is made. This can add significantly to distress and delays treatment. This article describes the clinical features of TN, differential diagnosis, initial management options and presents guidance on referral to secondary care.