Evidence Checklist: Trigeminal Neuralgia

Neurologist evaluation documenting trigeminal neuralgia diagnosisCritical

A neurologist's evaluation confirming the diagnosis, describing the pain distribution (V1/V2/V3 branches), trigger factors, attack frequency, and severity.

MRI brain with trigeminal protocol (neurovascular contact or MS lesion)Critical

MRI with FIESTA/CISS sequences assessing for vascular compression of the trigeminal nerve root or demyelinating plaques. Supports diagnosis and nexus.

Nexus opinion linking trigeminal neuralgia to service ("at least as likely as not")Critical

Medical opinion connecting your trigeminal neuralgia to in-service facial trauma, TBI, dental injury, or other service event.

Treatment records (medications, nerve block, surgery)

Records of carbamazepine/oxcarbazepine trials, nerve blocks, gamma knife, or microvascular decompression surgery, documenting response and residual symptoms.

Pain diary documenting attack frequency, duration, and severityCritical

A personal log recording each episode of lancinating facial pain. The VA rates trigeminal neuralgia under DC 8205 based on the severity and frequency of attacks.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Cranial Nerve ConditionsCritical

VA standardized form capturing cranial nerve examination findings and functional impact for rating under the cranial nerve diagnostic codes.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.