TRIGEMINAL NEURALGIA: PATHOPHYSIOLOGY, DIAGNOSIS AND MODERN MANAGEMENT APPROACHES

Trigeminal neuralgia (TN) is a chronic facial pain syndrome characterized by brief, recurrent episodes of intense, unilateral, shock-like pain within the sensory distribution of the trigeminal nerve. Despite its relatively low prevalence, the disorder causes marked functional disability and deterioration in quality of life. The underlying mechanism in classical TN is most commonly neurovascular compression that induces focal demyelination and abnormal excitability of trigeminal fibers. Secondary forms may develop in association with demyelinating diseases, tumors, or structural intracranial pathology. Diagnosis relies primarily on clinical evaluation, supported by neuroimaging to exclude secondary etiologies. Pharmacological therapy with sodium channel–modulating anticonvulsants remains first-line treatment, while surgical interventions are reserved for refractory cases. This article presents a synthesized overview of current concepts regarding the mechanisms, diagnosis, and management of trigeminal neuralgia.