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Trigeminal neuralgia is sudden, severe facial pain. It is often described as sharp shooting pain or like having electric shock in the jaw, teeth or gums. Clinical features are so specific that it usually suffices the diagnosis in maximum cases. The general trend for management is to start with medical therapy and consider surgical procedures in patients refractory to medical treatment. Altering the doses of various drugs in “hit and trial” method is commonly practiced. Adjuvants have supra-additive effect to medical therapy. Decision to continue or discontinue medical therapy is the interplay between patient’s age, systemic condition, and response to drug therapy. Surgical options are reserved because of lack of identifiable cause(s) of disease and the associated complications. The cost of surgery is still a luxury for many of the patients. Various adjuvant measures are being tried specially with medical therapy and have shown various degree of success for pain relief. The aim of this narrative review was to compile together the latest updates in the management of trigeminal neuralgia in all possible fields such as medical and surgical management and adjuvant measures.

Medical management; surgical therapy; trigeminal neuralgia.