Trigeminal neuralgia type 1

Patients with trigeminal neuralgia type 1 experience a memorable onset of symptoms often described as a “lightning-bolt of pain that came out of nowhere.” The pain, while severe, tends to last for only seconds at a time and may occur many times per day. Even though attacks become more frequent, the pain is always shock-like and never constant or dull. Although attacks often occur spontaneously, patients with type 1 TN usually report certain triggering factors such as cold wind, eating, drinking, or using a washcloth. Additionally, patients with type 1 TN tend to have spontaneous remissions of symptoms lasting days to weeks early in the course of the disease with these pain-free intervals becoming shorter and less frequent as time passes. Patients with type 1 TN have the most favorable outcomes following any treatment modality.

Patients presenting with trigeminal neuralgia type 1 (TN1) without neurovascular compression (NVC) were predominantly females in their mid-30s with short symptom duration. In the absence of NVC, this subgroup of TN1 patients has limited surgical options, and potentially a longer condition duration that must be managed medically or surgically. This population without neurovascular compression (NVC) might provide insights into the true pathophysiology of TN1 ¹⁾.