Headache and Pain Research

Review Article

Trigeminal Neuralgia: Pathophysiology, Clinical Features, and Therapeutic Management: Ekene Nnagha, Chidubem Adi, Daniel Akpan; Received January 27, 2026 Accepted March 17, 2026 Published online June 4, 2026; DOI: https://doi.org/10.62087/hpr.2026.0005 [Epub ahead of print]

Abstract PDF: Trigeminal neuralgia (TN) is a severe, disabling neuropathic facial pain disorder classified among cranial neuralgias within headache medicine. Despite well-established diagnostic criteria, TN remains frequently misdiagnosed, particularly in dental and primary care settings. This review provides a clinically focused overview of the epidemiology, pathophysiology, classification, diagnostic approach, and contemporary management of TN, with relevance to headache and pain research and clinical practice. Neurovascular compression with focal demyelination at the trigeminal nerve root entry zone is considered the predominant mechanism in classical TN. Diagnosis is primarily clinical and guided by International Classification of Headache Disorders, 3rd edition criteria, with magnetic resonance imaging essential for excluding secondary and idiopathic causes. Carbamazepine and oxcarbazepine remain first-line therapies, whereas microvascular decompression and minimally invasive neurosurgical procedures provide effective options for medically refractory disease. TN requires accurate diagnosis and individualized management. Advances in pharmacological and interventional treatments have improved outcomes and underscore the importance of multidisciplinary care within headache and pain medicine.

Case Report

Three Cases of Secondary Trigeminal Neuralgia Caused by Maxillary Sinus Cyst: Eungue Lee, Wonseok Jeon, Joongwon Park, Junho Choi, Jong-Hee Sohn, Ho Jun Lee, Sang-Hwa Lee; Korean J Headache. 2023;24(1):28-31. Published online June 30, 2023

Abstract PDF: Trigeminal neuralgia is a neuropathic pain disorder characterized by elicited paroxysms of stabbing pain in a specific region. Trigeminal neuralgia is classified into three types: classical, secondary, and idiopathic. The classic type, which is the most common, is caused by vascular compression of the trigeminal nerve root. Carbamazepine and oxcarbazepine are the first-line treatment choice for trigeminal neuralgia and offer meaningful pain control in almost 90% of patients. However, if there is no response to medical treatment, secondary trigeminal neuralgia should be considered. Secondary trigeminal neuralgia is attributed to an identifiable neurologic disease. Additionally, there are various secondary causes such as skull base fractures and paranasal sinus lesion. Two cases of secondary trigeminal neuralgia caused by maxillary sinus cyst were previously reported in South Korea. We experienced 3 cases of secondary trigeminal neuralgia induced by maxillary sinus cyst, which exhibited different clinical and radiological findings compared to the previous cases.

Search