Recurring as often as 100 times a day, the pain can be totally incapacitating. Although no specific test exists for identifying trigeminal neuralgia, its characteristic pain makes it easy for a doctor to diagnose. Doctors also evaluate other possible causes of facial pain, such as diseases of the jaw, teeth, or sinuses or compression of the trigeminal nerve by a tumor or aneurysm. Carbamazepine is usually tried first, but phenytoin may be prescribed if carbamazepine doesn't work or produces severe side effects. Baclofen and several antidepressant drugs also help in some cases.
Spontaneous remissions are common, but bouts of the disease often recur at wide intervals.
In such cases an operation can separate the artery from the nerve and relieve the pain for at least a few years. For people with pain that can't be relieved by drugs and who may not be good candidates for surgery, a test can be done in which alcohol is injected into the nerve, temporarily blocking its function. If this relieves the pain, the nerve can be cut or permanently destroyed by injecting a drug into it. Such approaches often produce discomfort in the face and should be regarded as a last resort. Glossopharyngeal Neuralgia Glossopharyngeal neuralgia is a rare disorder in which a person has recurring attacks of severe pain in the back of the throat near the tonsils, sometimes affecting the ear on the same side.