• 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.

 

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