Others may experience intense pain in one or in all three trigeminal nerve branches, affecting teeth, ears, sinuses, cheeks, forehead, upper and lower jaws, behind the eyes, and scalp.

[citation needed] Both forms of facial neuralgia are relatively rare, with an incidence recently estimated between 12 and 24 new cases per hundred thousand population per year.

[3][4] ATN often goes undiagnosed or misdiagnosed for extended periods, leading to a great deal of unexplained pain and anxiety.

In desperate efforts to alleviate pain, some patients undergo multiple (but unneeded) root canals or extractions, even in the absence of suggestive X-ray evidence of dental abscess.

[citation needed] ATN symptoms may also be similar to those of post-herpetic neuralgia, which causes nerve inflammation when the latent herpes zoster virus of a previous case of chicken pox re-emerges in shingles.

The pain is usually constant, described as aching or burning, and often affects both sides of the face (this is almost never the case in patients with trigeminal neuralgia).

The pain frequently involves areas of the head, face, and neck that are outside the sensory territories that are supplied by the trigeminal nerve.

As of July 2011, this axis of the DSM-IV is undergoing major revision for the DSM-V, with introduction of a new designation "Complex Somatic Symptom Disorder".

Bright lights, sounds, stress, and poor diet are examples of additional stimuli that can contribute to the condition.

However, the diagnosis for ATN can be supported by a positive response to a low dose of tricyclic antidepressant medications (such as amitriptyline or nortriptyline), similar to neuropathic pain diagnoses.

[citation needed] If the anti-seizure drugs are found ineffective, one of the tricyclic antidepressant medications, such as amitriptyline or nortriptyline, may be used.

[citation needed] For some people with ATN opioids may represent the only viable medical option which preserves quality of life and personal functioning.

[15][16][17] If drug treatment is found to be ineffective or causes disabling side effects, one of several neurosurgical procedures may be considered.

Some neurosurgeons resist the application of MVD or other surgeries to atypical trigeminal neuralgia, in light of a widespread perception that ATN pain is less responsive to these procedures.