Trigeminal N euralgia - TN: diagnosis and management challenges

Trigeminal Neuralgia (TN), also known as prosopalgia or “Fothergill’s disease”, or “suicide disease”, was first described by Fehr and Locke at the end of the seventeenth century. Subsequently, Trousseau introduced the nomenclature Epileptiform Neuralgia” based on a pathophysiological connotation, and in 1756, Nicholas André coined the term Tic Douloureux”. Prosopalgia was presented shortly thereafter by John Fothergill (“Fothergill’s disease”) to the Medical Society in London, England, in 1773. The diagnosis of this chronic neuropathic disorder is clinically based on a normal neurological examination in patients presenting with paroxysmal pain, usually intermittent and unilateral, in one (or more) of the trigeminal nerve branches. All tests show normal results, except in the symptomatic form of the disease. In this paper, we review and discuss the clinical aspect of TN diagnosis and management.