Summary

  • Facial pain syndrome in the distribution of ≥1 divisions of the trigeminal nerve.
  • Diagnosis is clinical, with a history of paroxysms of sharp, stabbing, intense pain lasting up to 2 minutes.
  • First-line therapy is medical, to which the majority of patients are partially responsive.
  • Surgical/ablative therapies are reserved for refractory cases.
  • Ablative therapies can cause facial sensory loss and are associated with a high recurrence rate; however, they are relatively noninvasive and carry minimal risk of severe morbidity/mortality.
  • Microvascular decompression has few long-term sequelae and well-established efficacy but has a potential risk of major morbidity.
  • More research on neurostimulation is needed to define its role in the treatment of trigeminal pain.

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