Trigeminal Neuralgia: A Review of the Clinical Features, Diagnosis and Management

Emma Carr; Peter Walker; Joanna Morrison

doi:doi:10.11648/j.ass.20221001.12

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Trigeminal Neuralgia: A Review of the Clinical Features, Diagnosis and Management

Emma Carr, Peter Walker, Joanna Morrison

Published in Advances in Surgical Sciences (Volume 10, Issue 1)

Received: 3 May 2022 Accepted: 18 May 2022 Published: 13 July 2022

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Abstract

Trigeminal Neuralgia has been described by the American Association of Neurological Surgeons as ‘one of the most excruciating pains known to humanity’. It can have a severe and detrimental effect on the patient’s quality of life, and many feel that they cannot perform simple daily tasks or worse still consider a future, whilst suffering this intolerable pain. As Trigeminal Neuralgia has a tendency to mimic pain of dental origin, patients may therefore first seek dental advice and treatment with the hope of gaining some immediate relief of their symptoms. This article discusses a recent case of Trigeminal Neuralgia, which had a delayed diagnosis. It discusses both the immediate management of an acute episode, and subsequent pharmacological treatment using Carbamazepine. Within this paper we also consider the psychological impact this condition has on a patient’s wellbeing and quality of life. We also outline how patients can receive additional support and guidance. This article aims to give dental practitioners and health care professionals an overview of the commonly presenting clinical features, diagnosis, and management of Trigeminal Neuralgia whilst discussing a recent case the authors managed within the dental setting. It also considers the crucial role dentists, in particular, general dental practitioners, can have in the initial management and subsequent onward referral.

Published in	Advances in Surgical Sciences (Volume 10, Issue 1)
DOI	10.11648/j.ass.20221001.12
Page(s)	7-12
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Cranial Nerve, Local Anaesthetic, Oral Medicine, Pain, Trigeminal Neuralgia, Trigeminal Nerve

References

[1]	American Association of Neurological Surgeons. Trigeminal Neuralgia. Available at: https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Trigeminal-Neuralgia. (Accessed April 2022).
[2]	IASP. IASP’s Proposed New Definition of Pain Released for Comment. Available at: https://www.iasp-pain.org/PublicationsNews/NewsDetail.aspx?ItemNumber=9218 (Accessed April 2022).
[3]	BBC News. Congenital Analgesia: The agony of feeling no pain. Available at: https://www.bbc.co.uk/news/magazine-18713585 (Accessed April 2022).
[4]	Fayaz A, Croft P, Langford RM, Donaldson LJ, Jones GT. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open 2016; 6: doi: 10.1136.
[5]	Gorczyca R, Filip R, Walczak E. Psychological aspects of pain. Ann Agric Environ Med 2013; 1: 23-7.
[6]	Breivik H, Borchgrevink PC, Allen SM, et al. Assessment of pain. BJA Br J Anaesth 2008; 101: 17–24.
[7]	British Pain Society. Pain Scales in Multiple Languages. Available at: https://www.britishpainsociety.org/british-pain-society-publications/pain-scales-in-multiple-languages/ (Accessed April 2022).
[8]	Couper M, Tourangeau R, Conrad FG, Singer E. Evaluating the effectiveness of visual analogue scales: A web experiment. Soc Sci Comput Rev 2006; 24: 227-45.
[9]	Delgado DA, Lambert BS, Boutris N, et al. Validation of Digital Visual Analogue Scale Pain Scoring With a Traditional Paper-based Visual Analogue Scale in Adults. J Am Acad Orthop Surg Glob Res Rev 2018; 2. doi: 10.5435/JAAOSGlobal-D-17-00088.
[10]	British Pain Society & Faculty of Pain Medicine Royal College of Anaesthetists. Outcome Measures. January 2019. Available at: https://www.britishpainsociety.org/static/uploads/resources/files/Outcome_Measures_January_2019.pdf (Accessed April 2022).
[11]	Zakrzewska JM. Trigeminal Neuralgia. Dent Update 2019; 46: 730-37.
[12]	Hegarty AM, Zakrzewska JM. Differential Diagnosis for Orofacial Pain, Including Sinusitis, TMD, Trigeminal Neuralgia. Dent Update 2011; 38: 396-408.
[13]	Zakrzewska JM, McMillan R. Trigeminal neuralgia: the diagnosis and management of this excruciating and poorly understood facial pain. Postgrad Med J 2011; 87: 410-6.
[14]	Katusic S, Beard CM, Bergstralh, Kurland LT. Incidence and clinical features of trigeminal neuralgia. Ann neuro 1990; 27: 89-95.
[15]	Cruccu G, Finnerup NB, Jensen TS et al. Trigeminal neuralgia: new classification and diagnostic grading for practice and research. Neurology 2016; 87: 1–9.
[16]	Bendtsen L, Zakrzewska JM, Heinskou TB et al. Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia. Lancet Neurol. 2020; 19: 784-96.
[17]	Zakrzewska JM, Jassim S, Bulman SJ. A prospective, longitudinal study on patients with trigeminal neuralgia who underwent radiofrequency thermocoagulation of the Gasserian ganglion. Pain 1999; 79: 51–8.
[18]	Zakrzewska JM, Patsalos P. Long-term cohort study comparing medical (oxcarbazepine) and surgical management of intractable trigeminal neuralgia. Pain 2002; 95: 259–66.
[19]	Zakrzewska, JM, Linskey, ME. Trigeminal neuralgia. BMJ Clin Evid 2014; 1207.
[20]	Zakrzewska JM. Insights: Facts and Stories Behind Trigeminal Neuralgia. Florida: Gainesville, Trigeminal Neuralgia Association. 2006; 1.
[21]	Collins JB, Song J, Mahabir RC. Onset and duration of intradermal mixtures of bupivacaine and lidocaine with epinephrine. Can J Plast Surg. 2013; 21: 51-3.
[22]	Baykal M., Kaplan M. Effects of oral carbamazepine with 2% lidocaine on maxillary and mandibular nerve blocks in trigeminal neuralgia. Duzce Med J. 2010; 12: 19–23.
[23]	Moore D, Chong MS, Shetty A, Zakrzewska JM. A systematic review of rescue analgesic strategies in acute exacerbations of primary trigeminal neuralgia. Br J Anaesth. 2019; 123: 385–96.
[24]	Di Stefano G, La Cesa S, Truini A, Crucci G. Natural history and outcome of 200 outpatients with classical trigeminal neuralgia treated with carbamazepine or oxcarbazepine in a tertiary centre for neuropathic pain. J Headache Pain. 2014; 15. doi: 10.1186/1129-2377-15-34.
[25]	NICE National Institute for Health and Clinical Care Excellence. Carbamazepine. Available at: https://bnf.nice.org.uk/drug/carbamazepine.html (Accessed April 2022).
[26]	Trigeminal Foundation. Nerve Injuries. Available at: http://trigeminalnerve.org.uk/about-us/patients-group/ (Accessed April 2022).
[27]	University of California. Well Institute for Neurosciences, Department of Neurological Surgery. Trigeminal Neuralgia FAQ. Available at: https://neurosurgery.ucsf.edu/trigeminal-neuralgia-faq (Accessed April 2022).
[28]	Eckardstein KL, Keil M, Rohde V. Unnecessary dental procedures as a consequence of trigeminal neuralgia. Neurosurg Rev. 2015; 38: 355-60.
[29]	Dental Protection. Local anaesthetic batch numbers. 2015. Available at: https://www.dentalprotection.org/uk/articles/local-anaesthetic-batch-numbers. (Accessed April 2022).

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APA Style

Emma Carr, Peter Walker, Joanna Morrison. (2022). Trigeminal Neuralgia: A Review of the Clinical Features, Diagnosis and Management. Advances in Surgical Sciences, 10(1), 7-12. https://doi.org/10.11648/j.ass.20221001.12

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ACS Style

Emma Carr; Peter Walker; Joanna Morrison. Trigeminal Neuralgia: A Review of the Clinical Features, Diagnosis and Management. Adv. Surg. Sci. 2022, 10(1), 7-12. doi: 10.11648/j.ass.20221001.12

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AMA Style

Emma Carr, Peter Walker, Joanna Morrison. Trigeminal Neuralgia: A Review of the Clinical Features, Diagnosis and Management. Adv Surg Sci. 2022;10(1):7-12. doi: 10.11648/j.ass.20221001.12

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@article{10.11648/j.ass.20221001.12,
  author = {Emma Carr and Peter Walker and Joanna Morrison},
  title = {Trigeminal Neuralgia: A Review of the Clinical Features, Diagnosis and Management},
  journal = {Advances in Surgical Sciences},
  volume = {10},
  number = {1},
  pages = {7-12},
  doi = {10.11648/j.ass.20221001.12},
  url = {https://doi.org/10.11648/j.ass.20221001.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20221001.12},
  abstract = {Trigeminal Neuralgia has been described by the American Association of Neurological Surgeons as ‘one of the most excruciating pains known to humanity’. It can have a severe and detrimental effect on the patient’s quality of life, and many feel that they cannot perform simple daily tasks or worse still consider a future, whilst suffering this intolerable pain. As Trigeminal Neuralgia has a tendency to mimic pain of dental origin, patients may therefore first seek dental advice and treatment with the hope of gaining some immediate relief of their symptoms. This article discusses a recent case of Trigeminal Neuralgia, which had a delayed diagnosis. It discusses both the immediate management of an acute episode, and subsequent pharmacological treatment using Carbamazepine. Within this paper we also consider the psychological impact this condition has on a patient’s wellbeing and quality of life. We also outline how patients can receive additional support and guidance. This article aims to give dental practitioners and health care professionals an overview of the commonly presenting clinical features, diagnosis, and management of Trigeminal Neuralgia whilst discussing a recent case the authors managed within the dental setting. It also considers the crucial role dentists, in particular, general dental practitioners, can have in the initial management and subsequent onward referral.},
 year = {2022}
}

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TY  - JOUR
T1  - Trigeminal Neuralgia: A Review of the Clinical Features, Diagnosis and Management
AU  - Emma Carr
AU  - Peter Walker
AU  - Joanna Morrison
Y1  - 2022/07/13
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DO  - 10.11648/j.ass.20221001.12
T2  - Advances in Surgical Sciences
JF  - Advances in Surgical Sciences
JO  - Advances in Surgical Sciences
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EP  - 12
PB  - Science Publishing Group
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AB  - Trigeminal Neuralgia has been described by the American Association of Neurological Surgeons as ‘one of the most excruciating pains known to humanity’. It can have a severe and detrimental effect on the patient’s quality of life, and many feel that they cannot perform simple daily tasks or worse still consider a future, whilst suffering this intolerable pain. As Trigeminal Neuralgia has a tendency to mimic pain of dental origin, patients may therefore first seek dental advice and treatment with the hope of gaining some immediate relief of their symptoms. This article discusses a recent case of Trigeminal Neuralgia, which had a delayed diagnosis. It discusses both the immediate management of an acute episode, and subsequent pharmacological treatment using Carbamazepine. Within this paper we also consider the psychological impact this condition has on a patient’s wellbeing and quality of life. We also outline how patients can receive additional support and guidance. This article aims to give dental practitioners and health care professionals an overview of the commonly presenting clinical features, diagnosis, and management of Trigeminal Neuralgia whilst discussing a recent case the authors managed within the dental setting. It also considers the crucial role dentists, in particular, general dental practitioners, can have in the initial management and subsequent onward referral.
VL  - 10
IS  - 1
ER  -

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Author Information

Emma Carr

Public Dental Service Ayrshire & Arran, Kilmarnock, ScotlandPublic Dental Service Ayrshire & Arran, Kilmarnock, Scotland
Peter Walker

Public Dental Service Ayrshire & Arran, Kilmarnock, Scotland
Joanna Morrison

Public Dental Service Ayrshire & Arran, Kilmarnock, Scotland

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Plain Text BibTeX RIS

APA Style

Emma Carr, Peter Walker, Joanna Morrison. (2022). Trigeminal Neuralgia: A Review of the Clinical Features, Diagnosis and Management. Advances in Surgical Sciences, 10(1), 7-12. https://doi.org/10.11648/j.ass.20221001.12

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ACS Style

Emma Carr; Peter Walker; Joanna Morrison. Trigeminal Neuralgia: A Review of the Clinical Features, Diagnosis and Management. Adv. Surg. Sci. 2022, 10(1), 7-12. doi: 10.11648/j.ass.20221001.12

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AMA Style

Emma Carr, Peter Walker, Joanna Morrison. Trigeminal Neuralgia: A Review of the Clinical Features, Diagnosis and Management. Adv Surg Sci. 2022;10(1):7-12. doi: 10.11648/j.ass.20221001.12

Copy | Download

@article{10.11648/j.ass.20221001.12,
  author = {Emma Carr and Peter Walker and Joanna Morrison},
  title = {Trigeminal Neuralgia: A Review of the Clinical Features, Diagnosis and Management},
  journal = {Advances in Surgical Sciences},
  volume = {10},
  number = {1},
  pages = {7-12},
  doi = {10.11648/j.ass.20221001.12},
  url = {https://doi.org/10.11648/j.ass.20221001.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20221001.12},
  abstract = {Trigeminal Neuralgia has been described by the American Association of Neurological Surgeons as ‘one of the most excruciating pains known to humanity’. It can have a severe and detrimental effect on the patient’s quality of life, and many feel that they cannot perform simple daily tasks or worse still consider a future, whilst suffering this intolerable pain. As Trigeminal Neuralgia has a tendency to mimic pain of dental origin, patients may therefore first seek dental advice and treatment with the hope of gaining some immediate relief of their symptoms. This article discusses a recent case of Trigeminal Neuralgia, which had a delayed diagnosis. It discusses both the immediate management of an acute episode, and subsequent pharmacological treatment using Carbamazepine. Within this paper we also consider the psychological impact this condition has on a patient’s wellbeing and quality of life. We also outline how patients can receive additional support and guidance. This article aims to give dental practitioners and health care professionals an overview of the commonly presenting clinical features, diagnosis, and management of Trigeminal Neuralgia whilst discussing a recent case the authors managed within the dental setting. It also considers the crucial role dentists, in particular, general dental practitioners, can have in the initial management and subsequent onward referral.},
 year = {2022}
}

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TY  - JOUR
T1  - Trigeminal Neuralgia: A Review of the Clinical Features, Diagnosis and Management
AU  - Emma Carr
AU  - Peter Walker
AU  - Joanna Morrison
Y1  - 2022/07/13
PY  - 2022
N1  - https://doi.org/10.11648/j.ass.20221001.12
DO  - 10.11648/j.ass.20221001.12
T2  - Advances in Surgical Sciences
JF  - Advances in Surgical Sciences
JO  - Advances in Surgical Sciences
SP  - 7
EP  - 12
PB  - Science Publishing Group
SN  - 2376-6182
UR  - https://doi.org/10.11648/j.ass.20221001.12
AB  - Trigeminal Neuralgia has been described by the American Association of Neurological Surgeons as ‘one of the most excruciating pains known to humanity’. It can have a severe and detrimental effect on the patient’s quality of life, and many feel that they cannot perform simple daily tasks or worse still consider a future, whilst suffering this intolerable pain. As Trigeminal Neuralgia has a tendency to mimic pain of dental origin, patients may therefore first seek dental advice and treatment with the hope of gaining some immediate relief of their symptoms. This article discusses a recent case of Trigeminal Neuralgia, which had a delayed diagnosis. It discusses both the immediate management of an acute episode, and subsequent pharmacological treatment using Carbamazepine. Within this paper we also consider the psychological impact this condition has on a patient’s wellbeing and quality of life. We also outline how patients can receive additional support and guidance. This article aims to give dental practitioners and health care professionals an overview of the commonly presenting clinical features, diagnosis, and management of Trigeminal Neuralgia whilst discussing a recent case the authors managed within the dental setting. It also considers the crucial role dentists, in particular, general dental practitioners, can have in the initial management and subsequent onward referral.
VL  - 10
IS  - 1
ER  -

Copy | Download