History and exam

Key diagnostic factors

common

stereotyped paroxysms of facial pain

Required for diagnosis. Pattern is important, as restriction to trigeminal distributions and quality, duration, and consistency of pain are critical for diagnosis of trigeminal neuralgia. The pain associated with TN is typically described as intense, sharp, superficial, stabbing, or burning in quality. Pain is usually unilateral, stereotyped, and lasts seconds to minutes.

attacks triggered by facial or oral mechanical stimulation

Triggers such as tooth brushing, eating, cold, and touch are common.

presence of risk factors

Key risk factors include increased age and multiple sclerosis.

Other diagnostic factors

uncommon

sensory/motor changes

Suggestive of secondary cause, e.g., multiple sclerosis, tumour.

Risk factors

strong

increased age

Incidence rates increase with age.[2]

multiple sclerosis

TN is significantly more common in people with multiple sclerosis.[10]​​​

weak

female

TN shows a female predisposition at all ages (3:2 female to male ratio).[2]

hypertension

Some studies have shown a slightly increased risk of TN in people with hypertension.[17]​​[18]​​

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