How to check for trigeminal neuralgia

Trigeminal neuralgia can be diagnosed through physical examination, imaging examination, and neuroelectrophysiological examination. This disease is usually caused by vascular compression of nerves or demyelinating lesions, manifested as facial electric shock like or knife like pain. It is recommended to seek medical examination as soon as possible.

1. Physical examination:

Doctors will induce pain by lightly touching specific areas of the patient's face, which are called trigger points and are commonly found near the nostrils, corners of the mouth, or eyebrows. During the examination, it is necessary to distinguish whether it is trigeminal neuralgia or other facial pain, such as toothache or temporomandibular joint disorder. If lightly touching the trigger point can induce typical pain, it highly supports the diagnosis of trigeminal neuralgia. This examination is non-invasive and rapid, and is the core step of clinical preliminary judgment.

2. Head magnetic resonance imaging:

Head magnetic resonance imaging is a key means of excluding secondary trigeminal neuralgia and can clearly display intracranial structures. This examination can detect the presence of tumors, multiple sclerosis plaques, or vascular malformations compressing the trigeminal nerve root. For example, abnormal course of the superior cerebellar artery or anterior inferior cerebellar artery may directly compress nerves, leading to pain. Through 3D reconstruction technology, doctors can accurately evaluate the relationship between nerves and blood vessels, providing a basis for subsequent treatment.

3. Magnetic resonance tomography angiography:

Magnetic resonance tomography angiography is specifically used to evaluate the relationship between the trigeminal nerve and surrounding blood vessels, and has high sensitivity in identifying the cause of vascular compression. This technology does not require injection of contrast agents and clearly displays the anatomical location of nerves and blood vessels through a special sequence. If the examination reveals close contact or compression between blood vessels and nerves, it can be confirmed as primary trigeminal neuralgia. This examination helps distinguish whether microvascular decompression surgery is necessary.

4. Trigeminal nerve evoked potential:

Trigeminal nerve evoked potential is used to electrically stimulate facial nerve endings, record nerve conduction velocity and waveform changes, and evaluate nerve function status. This examination can objectively reflect the degree of nerve demyelination or axonal injury. If the waveform is delayed or the amplitude decreases, it indicates abnormal nerve conduction. This method is particularly suitable for patients with atypical symptoms or those whose physical examination cannot provide a clear diagnosis, and can assist in determining the location and severity of lesions.

5. cerebrospinal fluid examination:

Cerebrospinal fluid examination is mainly used to exclude secondary trigeminal neuralgia caused by infectious or inflammatory diseases, such as herpes zoster virus or autoimmune encephalitis. Obtain cerebrospinal fluid samples through lumbar puncture, analyze cell count, protein content, and pathogen antibodies. If there is an increase in white blood cells or positive oligoclonal bands in cerebrospinal fluid, demyelinating diseases such as multiple sclerosis should be considered. This examination is an invasive procedure and is only used when a specific cause is highly suspected.

Daily attention should be paid to avoiding excessive fatigue and emotional excitement, reducing facial exposure to cold or cold wind stimulation, choosing warm and soft foods in diet, and avoiding chewing hard or overly hot foods. If the pain recurs, it is recommended to record the frequency and causes of the attacks, and promptly follow up to adjust the treatment plan. Following medical advice for standardized examinations can help identify the cause and develop personalized intervention strategies.