An Approach of Trigeminal Neuralgia for General Practitioner: A Literature Review

Abstract: Trigeminal neuralgia is a chronic neuropathic pain of the face caused by the dysfunction of the fifth cranial nerve (trigeminal). The characteristics of the pain are described as severe pain resembling an electric shock lasting from a second to minutes, mostly unilateral, with allodynia at the pain location corresponding to the trigeminal nerve innervation. The exact mechanism causing trigeminal neuralgia is still unknown. An appropriate diagnostic and management approach to trigeminal neuralgia is crucial for improving the quality of life of patients.  Methods: This literature review uses various types of sources, such as articles in scientific journals and guidelines from government and related institutions. Article searches were conducted on online journal publication portals such as the National Center of Biotechnology Information (NCBI) (ncbi.nlm.nih.gov). Results: The diagnosis of trigeminal neuralgia is established based on clinical history and physical examination, particularly a thorough neurological examination. Supportive examinations such as MRI/angiography can be used to rule out differential diagnoses and determine the location of trigeminal nerve damage. The recommended pharmacological management for trigeminal neuralgia is the anticonvulsant medication carbamazepine. Other alternative therapies that can be performed include neuroleptic block therapy and surgery. Conclusion: An appropriate diagnostic and management approach in cases of trigeminal neuralgia can improve the quality of life for patients.