| Summary: | According to the international headache society (IHS), trigeminal neuralgia (TN) is a disorder characterized by recurrent unilateral brief, shock-like pain abrupt in onset and termination, limited to the distribution of one or more divisions of the trigeminal nerve. Peak incidence is between the ages of 50 and 60 years, more common in women. Patients with TN are best managed by coordinated multidisciplinary approach (medical and surgical management). Early surgery helps the patient to have a better quality of life rather than waiting with the medical therapy alone. Here we present a case of an old aged male patient with h/o right side facial pain in V1 and V2 distribution, diagnosed with trigeminal neuralgia, and was on prolonged drug therapy for the same with no signs of improvement. We subjected the patient for Microvascular decompression after confirming the vascular loop compressing the ipsilateral trigeminal nerve. Patient showed improvement with symptom free interval subsequently.
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