How is trigeminal neuralgia diagnosed?

Written by Chen Yu Fei
Neurosurgery
Updated on April 17, 2025
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The diagnosis of trigeminal neuralgia is mainly based on the patient's clinical symptoms. It is mostly characterized by transient pain around the bilateral nasal root and corners of the mouth. There are generally no obvious prodromal symptoms before an attack; the pain occurs suddenly and stops suddenly. The nature of the pain is quite sharp, resembling knife-like cuts or a burning stabbing sensation. There are generally no significant signs before an onset, and the duration of an attack varies, lasting from a few seconds to several seconds, and even up to one or two minutes. Most patients experience sudden attacks and sudden cessation. Additionally, recurrent attacks can lead to severe adverse symptoms in patients and may even cause psychosomatic illnesses.

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What should I do if trigeminal neuralgia recurs?

After the recurrence of trigeminal neuralgia, oral medication can be considered as the initial treatment. If the effect of the medication is not clear, or the side effects are intolerable, then balloon compression or radiofrequency treatment can be considered. These two methods can be used repeatedly, but they also have a certain recurrence rate. If neither medication nor radiofrequency treatment achieves satisfactory results, then surgical treatment can be considered. Microvascular decompression surgery of the trigeminal nerve can be performed under a microscope, where the trigeminal nerve and the blood vessel compressing it are separated, which can fundamentally resolve trigeminal neuralgia. (Specific medications should be used under the guidance of a physician.)

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What should I do about trigeminal neuralgia of the teeth?

Trigeminal neuralgia in the teeth is generally caused by lesions in the areas controlled by the trigeminal nerve, leading to pain. This pain has trigger points, which could be a particular patch of skin or triggered during face washing, producing paroxysmal, electric shock-like pain. It is important to differentiate this from tooth-related nerve pain. Sometimes toothache may resemble symptoms of trigeminal neuralgia. If dental treatment does not relieve the pain, it might be trigeminal neuralgia related to the teeth. Trigeminal neuralgia requires medication, and there are many types of treatments available. If medicinal treatment proves ineffective, surgical treatment or acupuncture may be employed. In severe cases, nerve tissue blockage can be performed to temporarily relieve the pain.

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Should people with trigeminal neuralgia avoid certain foods?

Patients with trigeminal neuralgia need to be cautious about their diet. In daily life, try to avoid oily, spicy, and irritating foods, as these types of foods may trigger an attack of trigeminal neuralgia or make the existing attacks more frequent, thereby causing great pain to the patient. It is recommended to choose a light diet in daily life, low in salt and fat, especially for patients with high blood pressure or diabetes, who need to be more cautious. It may be beneficial to appropriately include some fresh vegetables and fruits in the diet, and it is also suggested to supplement with some multivitamin drugs, which might enhance the effects. If trigeminal neuralgia attacks frequently, it is still recommended to visit a local hospital in a timely manner and consider undergoing microvascular decompression surgery for treatment.

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Radical treatment method for trigeminal neuralgia

The fundamental cause of trigeminal neuralgia lies in the compression of the trigeminal nerve root by aberrant blood vessels around the area where it exits the brain stem. This compression leads to demyelination of the trigeminal nerve and causes a short circuit in the trigeminal nerve conduction pathway, resulting in trigeminal neuralgia. Currently, the only definitive cure for trigeminal neuralgia is microvascular decompression surgery. This surgery addresses the cause of trigeminal neuralgia by opening the skull, locating the trigeminal nerve and the compressing vessel, and placing a cushion between the nerve and the vessel to achieve a cure. This type of surgery is characterized by minimal trauma, preservation of nerve function, rapid recovery, and low complication rates, making it the best treatment for trigeminal neuralgia that can achieve a definitive cure.

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Will trigeminal neuralgia cause facial swelling?

Trigeminal neuralgia, if very severe, can also cause facial swelling. This is because the muscle tissue in the human body has a neurotrophic function, meaning that its nerves do not only play a controlling role but also have a nutritive function. If the pain from the trigeminal neuralgia is continuously severe, this can lead to the loss of the nutritive function, and over time it might cause muscle edema. Therefore, in such cases, it is crucial to promptly determine any changes in the condition and proceed with the necessary examinations and treatments early on to reduce problems of facial swelling caused by severe trigeminal neuralgia pain later. This often appears in the later stages and indicates that the condition has become relatively severe, requiring timely treatment.