Background: Trigeminal neuralgia is a painful neurological disorder that affects one or more of the divisions of the trigeminal nerve. It is characterized by brief attacks of stabbing pain that can be excruciating. These attacks may be triggered by a light touch, shaving, or even eating. There has been much debate over the exact etiology of trigeminal neuralgia. One of the main theories is vascular compression of the trigeminal nerve as it leaves the brainstem. Another theory suggests that intracranial tumors--particularly those located in the posterior fossa--may be the cause. Trigeminal neuralgia is also associated with multiple sclerosis.
Case report and review: A 79-year-old man came to the eye clinic with signs and symptoms consistent with trigeminal neuralgia involving the ophthalmic and maxillary divisions of the nerve. A neurological evaluation confirmed the diagnosis, and proper medical treatment was subsequently implemented to relieve his pain.
Conclusion: Patients who manifest symptoms consistent with trigeminal neuralgia should be referred for a neurological evaluation, including MRI. With the proper medical and/or surgical treatment, the quality of life of these patients can increase dramatically.