Trigeminal neuralgia is usually suspected based on the presence of symptoms that are characteristic of the condition. The diagnosis is confirmed after a detailed examination and imaging studies have been performed.
A general outline for the diagnosis of trigeminal neuralgia is given below:
In most cases, the pain occurs in the teeth, lower jaw or gums, and sufferers often seek help from their dentist as a first approach. This may sometimes delay a diagnosis of trigeminal neuralgia, because more common causes of the facial pain are investigated first.
To diagnose trigeminal neuralgia, a GP will check the patient’s face to ascertain exactly where the pain is felt as well as asking about the details of the patient’s symptoms and any potential trigger factors for the condition.
Next, a detailed examination of the head, ears, mouth, neck, teeth and jaws is performed to check for any other possible causes of the patient’s pain. Other conditions that need to be ruled out include dental infection, broken tooth, migraine, jaw pain, temporal arteritis, facial nerve injury and idiopathic facial pain. Trigeminal neuralgia caused by another condition is referred to as symptomatic trigeminal neuralgia.
A magnetic resonance scan (MRI) is then performed to show whether the trigeminal nerve is compressed. This procedure can also help to rule out other conditions that may be causing the pain such as a tumor in the brain stem, for example.
The GP will also need to rule out multiple sclerosis, a chronic degenerative condition affecting the nerve fibres in the brain and spinal cord. Trigeminal neuralgia occurs in around 1% to 5% of those with multiple sclerosis.
Reviewed by Sally Robertson, BSc