الفهرس 
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Abstract
INTRODUCTION
T
rigeminal neuralgia is defined by the IASP (International Association for the study of pain) as a sudden, unilateral, brief stabbing recurrent episodes of pain in the distribution of the trigeminal nerve branches, affecting the quality of life.1
Trigeminal neuralgia is also coined with ‘tic douloureux’: is a syndrome characterized by paroxysmal attacks of pain. Via myelinated A-fibers, it is caused by non-nociceptive stimuli such as yawning, chewing, light touch, and other transmitted stimuli.1
The diagnosis is usually made based on the patient’s history and the absence of neurological deficits, except for discrete hypoalgesia, thermo hypesthesia, or mechanoreceptive hypoesthesia in the trigger area.2
Trigeminal neuralgia may be “classical” or “symptomatic”. The term classical, refers to trigeminal neuralgia (TN) of unknown cause. While The secondary or symptomatic trigeminal neuralgia is due to other causes such as tumors or demyelinating lesions.3
The pathogenesis of TN and the effect of the different surgical procedures are not completely understood until now.4 However, The neurovascular conflict theory is a cause widely accepted and can also explain other cranial rhizopathies.5
Facial pain is a complex issue that may originate not only from the nerves but also from other facial structures. The most important issue is the sound clinical diagnosis of the trigeminal neuralgia, as the importance of investigations is limited to reveal secondary causes or compressing vascular loop. For a better assessment of facial pain different specialties can be involved to rule out other non-neurological causes of facial pain like dentists and neurologists.
Treatment options for the trigeminal neuralgia include medical treatment6, 7, ablative procedures (Gasserian ganglion percutaneous techniques, gamma knife surgery)8,9and non-ablative procedure (microvascular decompression).