Constant pain

In secondary trigeminal neuralgia, the pain is often:

• Constant or background pain (burning, aching)
• Superimposed paroxysms (sharp, electric shocks) may still occur
• Less responsive to typical medications (e.g., carbamazepine) than classical TN

This constant component is a red flag suggesting a structural or secondary cause (e.g., tumor, MS plaque, AVM).