to diagnose trigeminal neuralgia

how is trigeminal neuralgia diagnosed, and what are some other possibilities that might be causes of the headache and facial pain?
The pain started years ago, on the left side of my forehead, then pain developed near the left eye,
around the eye, in the eye (like a painful spear, excruciating pain in the head and eye); then pain
moved to include the left side of the mouth, gums, tongue.  Sometimes it feels like a painful wire that is either burning or ice cold in the left side of my face and left eye.   I use an ice pack at bedtime on my forehead to try to decrease pain in order to sleep.
What else could it be if it isn't trigeminal neuralgia? (sinusitis?)
If it is trigeminal neuralgia - will it ever go away (it seems to worsen when I experience increased stress).  
Thanks

[bern1007]

I HAVE JUST BEEN DIAGNOSED WITH TRIGEMINAL NEURALGIA.
It is not diagnosed, but all other things are ruled out.   My neuraligist has perscibed Lyrica and I haven't taken a advil since.  The Dr says it is treatable and will subside but must be treated with this anti seizure medicine given to epileptic.  I feel fine for 3 days now!  Good luck it is a frustrating journey.

[Abhijeet Deshmukh, MD]

Hello.

Trigeminal neuralgia is commonly caused by infection (Herpes), multiple sclerosis (rare) or by any tumor or growth which compresses the nerve.

The symptoms can be brought on by light touch or even a breeze coming on the face.

Some patients get migraine like headaches with trigeminal neuralgia.

If it is not trigeminal neuralgia, such symptoms can be seen with cluster headaches. Have you been taking any anticonvulsant medication ? Carbamazepine (Tegretol) is a particularly useful one. But there are others also.

Trigeminal Neuralgia may take a long time to be controlled.

Regards

[sunshine20618]

I have been told that TN will never get better, but as time goes on it usually gets worse.  I have had it 4 years and I am 26.  These are the meds I have tried: neurontin, tegretol, keppra, lamictal, dylantin, and I am getting the best results with a combination of trileptal and pamelor combined.  I also SWEAR by vitamin B12. I started at a low dose but I am now on 2000 MICRO grams 2x/day.  Try the b12 in combination with any anti-seizure drug.