Trigeminal Neuralgia: Channels, Pathophysiology, and Therapeutic Challenges

  • Daniele Cazzato
  • Stine Maarbjerg
  • Lars Bendtsen
  • Giuseppe LauriaEmail author
Part of the Headache book series (HEAD)


Trigeminal neuralgia (TN) is a condition characterized by paroxysmal excruciating and usually unilateral pain attacks within the territory of one or more divisions of the trigeminal nerve. The underlying pathophysiological mechanisms remain poorly understood. The abrupt onset and termination of electric shock-like severe pain, the triggering role of non-noxious light sensory stimuli, the spreading of pain beyond the stimulated area, and the post-attack refractoriness represent some of the intriguing and challenging aspects of TN pathophysiology. This chapter reviews the updated pathophysiological hypotheses for TN, the emerging role of ion channels potentially representing novel therapeutic targets for the treatment of the disorder, and the current therapeutic approach based on a diagnostic work-up and treatment algorithm.


Trigeminal neuralgia Neuropathic pain Ion channels Voltage-gated sodium channels (VGSC) Calcium-activated potassium channels (BKCa) Calcium channels Transient receptor potential (TRP) channels Chronic constriction injury of the infraorbital nerve (CION) Carbamazepine Eslicarbazepine OnabotulinumtoxinA Neurovascular compression 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Daniele Cazzato
    • 1
  • Stine Maarbjerg
    • 2
  • Lars Bendtsen
    • 2
  • Giuseppe Lauria
    • 3
    • 4
    Email author
  1. 1.Neurophysiology and Neuroalgology Units, Department of Clinical NeuroscienceIRCCS Foundation “Carlo Besta” Neurological InstituteMilanItaly
  2. 2.Department of Neurology, Danish Headache Center, Rigshospitalet—GlostrupUniversity of CopenhagenCopenhagenDenmark
  3. 3.Department of Biomedical and Clinical Sciences “Luigi Sacco”University of MilanMilanItaly
  4. 4.Neuroalgology Unit, Department of Clinical NeuroscienceIRCCS Foundation “Carlo Besta” Neurological InstituteMilanItaly

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