Trigeminal Neuralgia and Beyond: Diagnosis, Mechanism and Multidisciplinary Management of Facial Pain*
Date: October 18, 2026
Time: 11:45 am to 12:45 pm
Room: Coral 3
Track: Interactive Lunch Workshop (ILW)
Session Description
Facial pain disorders present significant diagnostic and therapeutic challenges. Trigeminal neuralgia—one of the most severe forms of neuropathic pain—is frequently misdiagnosed due to overlapping features with other facial pain syndromes. This session will review the comprehensive evaluation and management of trigeminal neuralgia and related conditions, including trigeminal neuropathy. Participants will gain updated insights into current treatment approaches, including pharmacologic therapies, botulinum toxin, and surgical interventions.
Learning Objectives
At the conclusion of this session, attendees will be able to:
- Differentiate trigeminal neuralgia from other facial pain syndromes, including trigeminal neuropathy.
- Apply evidence-based diagnostic strategies in the evaluation of facial pain disorders.
- Assess current medical, botulinum toxin, and surgical treatment options for trigeminal neuralgia and related conditions.
Speakers
Trigeminal Neuralgia: Diagnosis, Medical Management, and the Role of Botulinum Neurotoxin
Description
Trigeminal neuralgia is a debilitating facial pain disorder that can be challenging to manage in patients who do not respond adequately to standard pharmacologic therapy. Growing evidence supports the use of botulinum neurotoxin as a minimally invasive treatment option for medically refractory disease, offering an alternative before or alongside surgical intervention.
This presentation will review the diagnosis and medical management of trigeminal neuralgia, with a focus on the evolving role of botulinum neurotoxin therapy. Participants will examine current diagnostic criteria and first- and second-line pharmacologic treatments before reviewing evidence from randomized controlled trials and meta-analyses evaluating the efficacy of botulinum neurotoxin. Topics will include proposed antinociceptive mechanisms, injection techniques, dosing strategies, adverse effect profiles, predictors of treatment response, and patient selection. The presentation will also examine where botulinum neurotoxin fits within the broader treatment algorithm relative to interventional and surgical options while highlighting important limitations in the current evidence base.
Attendees will leave with a greater understanding of the evidence supporting botulinum neurotoxin for trigeminal neuralgia and practical guidance for integrating this therapy into comprehensive, evidence-based management strategies for patients with refractory facial pain.
Surgical Treatment of Trigeminal Neuralgia
Description
Trigeminal neuralgia is one of the most severe chronic pain disorders, often causing debilitating facial pain that significantly impacts quality of life. While many patients achieve symptom relief with medication, others require surgical intervention when pain becomes medically refractory or treatment-related side effects limit therapeutic options. Understanding the indications, benefits, and risks of available surgical approaches is essential for optimizing patient outcomes.
This presentation will provide a neurosurgical perspective on the treatment of trigeminal neuralgia, reviewing the indications for surgical intervention and the range of available treatment options. Participants will explore the principles, patient selection, outcomes, and potential complications of procedures such as microvascular decompression, stereotactic radiosurgery, and percutaneous techniques. Topics will also include how surgical decision-making is individualized based on patient characteristics, disease severity, and treatment goals.
Attendees will leave with a greater understanding of the role of surgery in managing trigeminal neuralgia and practical insights into selecting appropriate candidates for surgical intervention and integrating neurosurgical treatment into comprehensive, patient-centered care.
When Facial Pain Doesn’t Fit Neuralgia: Diagnosis and Management of Facial Pain Disorders
Description
Not all facial pain is trigeminal neuralgia. A wide range of facial pain disorders can present with overlapping symptoms, making accurate diagnosis and appropriate management challenging. Distinguishing among these conditions is critical to avoiding misdiagnosis, guiding treatment decisions, and improving patient outcomes.
This presentation will explore the clinical features, diagnostic challenges, and management of facial pain disorders that fall outside of the trigeminal neuralgia presentations, including trigeminal neuropathy, idiopathic persistent facial pain, trigeminal trophic syndrome, burning mouth syndrome, and temporamandibular disorders encompassing both joint pathology and myofascial pain involvement of masticatory muscles. Participants will review the key clinical characteristics that distinguish these conditions, common diagnostic pitfalls, and evidence-based, multidisciplinary approaches to evaluation and treatment.
Attendees will leave with a deeper understanding of the diverse spectrum of facial pain disorders and practical strategies for accurately diagnosing and effectively managing patients whose symptoms extend beyond classical trigeminal neuralgia.
