Trigeminal neuralgia

Abstract

We present a case of a 45-year-old woman with a diagnosis of a typical first branch trigeminal neuralgia (TN), who after 4 years of onset started experiencing lacrimation during her most severe attacks. Autonomic features, accompanying the pain attack, might lead to some diagnostic difficulties and doubts about differentiating first branch TN from other similar pain disorders like the short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT). The following question was asked: “Should the lacrimation be considered as a part of the patient’s first branch trigeminal neuralgia or a transformation of the TN to SUNCT might have occurred?”