Trigeminal Neuropathic Pain

Trigeminal neuropathic pain (TNP) involves pain isolated to the distribution of one or more branches of the trigeminal nerve following unintentional injury to that nerve. It is important to distinguish this facial pain syndrome from trigeminal neuralgia, as the treatment is quite different. The diagnosis is typically clinical, although local anesthetic blocks may aid in the diagnosis. Psychological testing is often performed preoperatively. Like other neuropathic pain syndromes, TNP may be treated with peripheral nerve stimulation. This chapter discusses a typical presentation of TNP, as well as the evaluation and management process, including placement of subcutaneous electrodes and connection to an internal pulse generator.