Trigeminal Neuralgia and Other Craniofacial Pain Syndromes: An Overview

Classic, idiopathic trigeminal neuralgia is an easily recognizable condition of excruciating, lancinating pain in one or more of the trigeminal distributions. Atypical features may exist (i.e., constant burning pains of a background nature) and we propose this condition represents the natural progression of trigeminal neuralgia type 1 to type 2. The etiology of trigeminal neuralgia is accepted as occurring from microvascular compression at the root entry zone, but other trigeminal facial pain syndromes exist and occur from iatrogenic (trigeminal deafferentation pain) or traumatic (trigeminal neuropathic pain) injuries. It is important to recognize when facial pain occurs in cranial nerve distributions other than the trigeminal nerve, as the treatments are different for geniculate, glossopharyngeal, and occipital neuralgia. Lastly, atypical facial pain occurs in a nonanatomic distribution and may be attributed to nonorganic or psychological causes. Pain from the facial sinuses, odontologic pain, and temporal mandibular joint pain are discussed.