Diagnosing Trigeminal Neuralgia

To diagnose trigeminal neuralgia most appropriately, healthcare providers need to conduct physical examinations while applying certain techniques described by Bickley (2013) in her guide. To check the fifth cranial nerve (trigeminal), it is important to examine the motor and sensory portions of the nerve. First, it is necessary to palpate the temporal and masseter muscles on each side of the face to analyze their contractions and observe how the patient can clench his or her teeth and move the jaw from one side to another (Bickley, 2013). When conducting this examination, a healthcare provider is interested in checking the work of these muscles to determine possible atrophy.

After examining the motor portion of the nerve, it is necessary to make the sensory test. Three divisions need to be examined: ophthalmic, maxillary, and mandibular (Bickley, 2013). A healthcare provider usually starts with light touches while using a wisp. He or she touches the patient’s forehead, cheeks, and chin while examining each of the nerve’s divisions (Bickley, 2013). The purpose of this examination is to analyze the patient’s responses or reactions to these touches.

After conducting the physical examination using light touches, it is also important to apply the technique of pain touches which are more intense in comparison to touching with the help of a wisp. Some sharp objects are usually utilized for this test because healthcare providers need to examine the patient’s response to pain. The final stage is the examination of corneal reflexes because changes in them can also be discussed as indicators of trigeminal neuralgia. These procedures are important to conduct the physical investigation of the trigeminal nerves.


Bickley, L. (2013). Bates’ guide to physical examination and history-taking (11th ed.). New York, NY: Lippincott Williams & Wilkins. Web.