Trigeminal neuralgia--an update

The purpose of this article is to give a concise review of the diagnosis and management of trigeminal neuralgia (TN), with particular emphasis on idiopathic TN and symptomatic TN. The clinical characteristics of both conditions are presented, and the suspected underlying etiologies are discussed. Because it is crucial for clinicians to be able to rule out pain unrelated to TN, a list of differential diagnoses is presented. The authors stress that the diagnosis of TN is made clinically; however, diagnostic imaging may be indicated in selected cases. Current pharmacological and neurosurgical options for the management of TN are discussed in detail. In light of the popularity of unconventional treatments in the United States, the value of acupuncture and homeopathy, both of which have been suggested by some authors for the treatment of TN, is critically assessed.