Trigeminal Neuralgia (TN) presents with unilateral, lancinating head and facial pain, affecting one or more of Cranial Nerve V's divisions.
The pain occurs in 1 to 5 second multiple attacks throughout the day. Symptoms may remit and recur.
TN is associated with trigger points, but lacks any associated focal neurologic deficit or abnormality.
These characteristics will help distinguish TN from other sources of unilateral headache, such as migraines, cluster headaches, sinusitis, and glaucoma.
There are a host of treatments for TN, including options such as medical management with anti-convulsants and/or muscle relaxants, surgical ablation, alcohol injection (induces numbness), glycerol injection (destroys affected part of nerve), balloon compression, and administration of electrical current.
Medical management with analgesics and muscle relaxants is typically the most appropriate, first-line treatment in the emergency department.
