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Up to 17.5% of autopsies of individuals who never had TN reveal vascular contact without significant neurovascular compression.16 Imaging techniques are able to identify significant neurovascular compression17 and differentiate it from simple contact, enabling better selection of surgical candidates, with classical series reporting no improvement after microvascular decompression in up to 30% of patients undergoing the procedure.18 Secondary trigeminal neuralgia Secondary TN presents with “recurrent paroxysms of unilateral facial pain meeting the diagnostic criteria for TN, either purely paroxysmal or associated with concomitant continuous or near-continuous pain,” in patients with a documented underlying disease recognised as a cause of the neuralgia, which would explain the pain
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The refusal to provide this essential treatment a day early, when the patient is symptomatic, is fundamentally different from a dietary suggestion
