A physician should be consulted if cranial neuralgia is suspected. Before a diagnosis can be made, a physician will likely review the patient’s medical history and perform a neurological examination. The medical history will include questions about a patient’s symptoms. Factors common to multiple occurrences of symptoms may indicate triggering mechanisms. The patient may be asked to complete a pain assessment form.

The neurological examination typically tests the patient’s reflexes, coordination and mental status. During this examination, a physician will look for any tenderness along the pathways of cranial nerves and whether any nerve dysfunction is present, such as abnormal reflex reactions.

To confirm a diagnosis of cranial neuralgia, the physician must first rule out other possible causes of head pain, such as migraines or other headaches, temporal arteritis, infections, fractures or arthritis. This is likely to require additional analyses, including blood tests. These tests can identify potential causes of cranial neuralgia, such as high blood sugar and kidney malfunction.

An electromyogram (EMG) and nerve conduction velocity study (NCS) test may also be performed to assess whether symptoms are the result of damage to the muscle or nerves, and the extent of damage. The EMG measures the health of muscle tissue, and the NCV test indicates the effectiveness of certain nerves. In some cases, a patient may be asked to undergo a dental examination to determine whether oral health factors are responsible for the patient’s pain.

Imaging tests may also be performed. This may include an MRI (magnetic resonance imaging) of the brain, which can indicate whether tumors or other structures are compressing a cranial nerve and causing a patient’s cranial neuralgia. MRIs may also help confirm nerve disorders that can cause cranial neuralgia, such as multiple sclerosis. In those cases, a spinal tap may also be performed.