Trigeminal neuralgia: therapeutic strategies to restore quality of life

Trigeminal neuralgia (TN) usually affects the maxillary and mandibular branches of the fifth cranial nerve. Although the condition is primarily unilateral, few cases of bilateral manifestation have been reported. TN is uncommon; however, it significantly affects patients' quality of life because the neuropathic pain worsens over time. Paroxysmal pain is triggered by mechanical stimuli or environmental factors. Diagnosis is usually based on clinical findings, including pain triggered by palpation of distinct areas; nevertheless, imaging studies, such as magnetic resonance imaging, are always used to rule out a secondary cause. TN can be caused by several factors, such as trauma and neurovascular compression, or could be idiopathic, which complicates its treatment. Although several studies focused on TN have been reported, a treatment modality with 100% efficacy is lacking. The first-line treatment is pharmacological; however, surgery may be required if symptoms persist.