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Table 19 Clinical characteristics in trigeminal neuralgia

From: Reference programme: diagnosis and treatment of headache disorders and facial pain. Danish Headache Society, 3rd edition, 2020

• Trigeminal neuralgia (TN) is a unilateral disorder of short-lasting stabbing pain paroxysms.
• The painful area typically involves the 2nd and/or 3rd trigeminal branch.
• The mean age of onset is 52 years, but the range of onset is wide (8–90 years).
• Pain attacks are evoked by light sensory stimuli such as chewing, touching the face, talking, tooth brushing, shaving and cold wind. There can also be spontaneous pain.
• Trigger zones are often located around the nasal wing and the lateral part of the upper and lower lip.
• Natural history of TN is unpredictable. There may be severe exacerbations of pain and there may be periods of complete pain remission lasting for weeks and months – in some cases even years.
• Symptomatic TN is caused by a brainstem plaque from multiple sclerosis or by a space-occupying lesion in the cerebellopontine angle cistern. At clinical presentation, it can be indistinguishable from primary TN.