Diagnosis and Management of Trigeminal Neuralgia, Implications for Athletes: Narrative Review

Abstract

Background: Trigeminal neuralgia (TN) is a chronic neuropathic pain disorder that causes sudden episodes of intense facial pain. Among athletes, recurrent pain attacks and the adverse effects of treatment may interfere with training, performance, and return to competition.   Aim: This review analyzes current diagnostic standards, pathophysiological mechanisms, and treatment options for TN. It highlights its impact on physical activity and the particular needs of athletic individuals.   Material and Methods: A literature search was conducted using electronic databases, including PubMed, with the following keywords: “Trigeminal neuralgia”, “Orofacial Pain”, and “Physical Activity”. The review included randomized controlled trials, meta-analyses, and systematic reviews from 1967 to the present, with most studies published between 2020 and 2025.   Results: TN is usually diagnosed based on clinical symptoms. Attacks involve sudden, one-sided, brief, and shock-like pain triggered by mild stimuli. MRI is the gold standard for detecting neurovascular compression. As a pharmacological treatment, carbamazepine is the first choice. However, its side effects, such as ataxia and dizziness, can strongly impair athletic performance. Surgical interventions, including microvascular decompression (MVD), have high long-term success rates and may be considered sooner for active people.   Conclusion: Managing TN requires a multidisciplinary approach that takes into consideration environmental triggers and the impact of medication on the quality of life.