Trigeminal Neuralgia

TN is a chronic neuropathic facial pain disorder characterized by paroxysmal, electric shock–like pain in trigeminal nerve distributions. Etiology includes neurovascular compression, demyelination, or secondary causes. Pathophysiology involves hyperexcitability of trigeminal afferent fibers. Diagnosis is clinical, supported by MRI to exclude secondary causes. Management includes anticonvulsants (carbamazepine, oxcarbazepine), surgical decompression, or ablative procedures; prognosis is variable, with episodic remissions and relapses.