The condition must be distinguished from other forms of facial pain which can arise from diseases of the teeth, jaw or sinuses. MRI or CT scan of the brain can exclude causes like tumor or aneurysm and should be part of the evaluation in patients in which trigeminal neuralgia is suspected. Trigeminal neuralgia can be treated both medically, with drugs, and surgically. For patients in whom the medications fail to provide relief, surgical approaches to trigeminal neuralgia are possible. Surgery is usually reserved for refractory cases of trigeminal neuralgia or when the undesired side effects of the medication are encountered.
Surgery consists of peripheral blocking procedures.
In these instances, the nerve can be blocked with substances like glycerol. Another procedure involves burning the trigeminal nerve with a very precisely placed probe. The most invasive measure involves decompressing the trigeminal nerve where it exist the brain stem. This procedure requires manipulation of the brain and cerebral arteries. The effects of the medications tend to suppress or shorten the duration of attacks, occasionally these effects are life long.