Editing Trigeminal neuralgia (section)

==Diagnosis==
Trigeminal neuralgia is diagnosed via the result of neurological and physical tests, as well as the individual's medical history.<ref name="NIH2015"/> [[Magnetic resonance angiography]] can be used to detect vascular compression of the trigeminal nerve and refer patients to surgery.<ref>{{cite journal | vauthors = Bora N, Parihar P, Raj N, Shetty N, Nunna B | title = A Systematic Review of the Role of Magnetic Resonance Imaging in the Diagnosis and Detection of Neurovascular Conflict in Patients With Trigeminal Neuralgia | journal = Cureus | volume = 15 | issue = 9 | pages = e44614 | date = September 2023 | pmid = 37799230 | pmc = 10547583 | doi = 10.7759/cureus.44614 | doi-access = free }}</ref>

As with many conditions without clear physical or laboratory diagnosis, TN is often misdiagnosed, and other conditions are also frequently misdiagnosed as TN.<ref name=":1">{{cite journal | vauthors = Antonaci F, Arceri S, Rakusa M, Mitsikostas DD, Milanov I, Todorov V, Ramusino MC, Costa A | title = Pitfals in recognition and management of trigeminal neuralgia | journal = The Journal of Headache and Pain | volume = 21 | issue = 1 | pages = 82 | date = June 2020 | pmid = 32605593 | pmc = 7325374 | doi = 10.1186/s10194-020-01149-8 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Slettebø H | title = Is this really trigeminal neuralgia? Diagnostic re-evaluation of patients referred for neurosurgery | journal = Scandinavian Journal of Pain | volume = 21 | issue = 4 | pages = 788–793 | date = October 2021 | pmid = 34333890 | doi = 10.1515/sjpain-2021-0045 | doi-access = free }}</ref> A person with TN may see three or four clinicians before a firm diagnosis is made.<ref name=":1" />

[[Temporomandibular joint dysfunction|Temporomandibular disorder]] (TMD) can present similarly to TN, and differentiating between these conditions can be difficult.<ref name="Drangsholt2001">{{cite journal |vauthors=Drangsholt M, Truelove EL |year=2001 |title=Trigeminal neuralgia mistaken as temporomandibular disorder |url=http://www.jebdp.com/article/S1532-3382%2801%2970082-6/abstract |journal=Journal of Evidence Based Dental Practice |volume=1 |issue=1 |pages=41–50 |doi=10.1067/med.2001.116846|url-access=subscription }}</ref> Even suspected TN patients who experience brief attacks of sharp pain have had their symptoms resolve after being treated for TMD.<ref>{{cite journal | vauthors = Ceneviz C, Maloney G, Mehta N | title = Myofascial pain may mimic trigeminal neuralgia | journal = Cephalalgia | volume = 26 | issue = 7 | pages = 899–901 | date = July 2006 | pmid = 16776712 | doi = 10.1111/j.1468-2982.2006.01123.x }}</ref> TMD pain can also be triggered by movements of the tongue or facial muscles, so TN must be differentiated from masticatory pain by differentiating between the clinical characteristics of deep somatic pain and neuropathic pain. Masticatory pain will not be arrested by a conventional mandibular local anesthetic block.<ref name="Okeson 2005 453" /> One quick test a dentist might perform is a conventional inferior dental local anesthetic block. If the pain is in the treated branch, the block will not arrest masticatory pain but will alleviate TN pain.<ref>{{cite web |date=9 December 2020 |title=Trigeminal Nerve Block |url=http://emedicine.medscape.com/article/2040595-overview |url-status=live |archive-url=https://web.archive.org/web/20151026075104/http://emedicine.medscape.com/article/2040595-overview |archive-date=26 October 2015 |access-date=20 November 2015 |website=MedScape |vauthors=Cherian A, Maroju NK |veditors=Raghavendra M}}</ref>