Diagnosing Trigeminal Neuralgia: 7-Step Clinical Workup

Diagnosis requires detailed symptom review, neurological exam, and tests to exclude other causes:

1. Symptom Assessment: Pain location, intensity, duration, triggers; trigeminal nerve distribution.
2. Neurological Exam: Corneal reflex, facial sensation, muscle tone/strength.
3. Imaging (MRI Brain with Gadolinium): Detect vascular compression, tumors, vascular malformations.
4. Electrophysiological Studies: Trigeminal SSEP (nerve function), facial EMG (weakness/denervation).
5. Differential Diagnosis: Exclude dental issues, sinusitis, TMJ disorders, cluster headaches, atypical facial pain.
6. Diagnostic Blocks: Trigeminal nerve blocks to pinpoint affected branch; pain relief confirms diagnosis.
7. Diagnostic Criteria: Combine symptoms, findings, imaging per international guidelines.

Thorough workup is critical to differentiate trigeminal neuralgia from other facial pain conditions and guide treatment.