Trigeminal Neuralgia (TN) is the most common type of neuropathic face pain, and it has a significant impact on the quality of life of those who suffer from it. The cause of the classic type has been identified as neurovascular conflict (NVC), however TN can be due to various disorders. There is no NVC or other aetiology of TN in the idiopathic form. However, the specific sequence of events and mechanisms that lead to TN remain unknown, although new research suggesting that an inflammatory environment may play a role. The development of novel magnetic resonance imaging (MRI) techniques such as voxel-based morphometry, diffusion tensor imaging, and three-dimensional time-of-flight magnetic resonance angiography has revealed fresh information on the pathophysiology of TN. Furthermore, the use of these enhanced MRI sequences in conjunction with volume-rendering software and neuronavigation techniques had a considerable impact on the surgical outcome of patients undergoing microvascular decompression. TN management is, in fact, pharmacological from the start; nonetheless, TN might gradually grow insensitive to medications, necessitating multimodal treatment. Despite the multiple techniques available, the outcomes are not entirely satisfactory, and the desire for more effective medications led to the development of new compounds and pharmacological procedures. Furthermore, some patients may develop drug resistance, necessitating a surgical surgery or radiation treatment. However, pain recurrence after one or more surgical procedures is common, and other rescue treatments, such as neuromodulation, may be required to manage the symptoms. These observations demonstrate the lack of a thorough understanding of TN pathophysiology. The purpose of this work was to review recent research on pathogenesis, diagnostics, medicinal and surgical treatments, and to discuss major developments in all of these domains.
Author(S) Details
Nicola Montano
Department of Neuroscience, Neurosurgery Section, Fondazione Policlinico Universitario a Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Alessandro Rapisarda
Department of Neuroscience, Neurosurgery Section, Fondazione Policlinico Universitario a Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
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