This disease can occur at any age, but usually strikes adults over 40. It is more common in women than in men. Diagnosis Trigeminal neuralgia can be difficult to diagnose. The cause of trigeminal neuralgia is not well understood. A predominant theory is that an artery or vein may be beating up against the nerve causing the pain.
Most patients initiate their medical treatment by seeing a neurologist.
Medical treatment involves trial and error with a variety of medicines. The surgical treatment for trigeminal neuralgia can be done in a variety of ways. The gold standard, the microvascular decompression, is the surgical procedure with the greatest track record and the longest lasting relief of pain. This is an operation involving an opening in the skull, just behind the ear. The neurosurgeon finds where the trigeminal nerve is exiting the brain stem, and usually finds a blood vessel in contact with the nerve.