One of the hallmarks of trigeminal neuralgia type 1 is that it can be triggered by something. So patients very, very quickly learn that these episodes of shock-like pain that they're experiencing on their face are sometimes randomly occurring, but there are a certain number of things that they can often do that reliably will cause the pain to occur. They very, very quickly learn what those are. Some of the more common ones are: touching the face, showering, chewing, for some patients talking. One of the peculiar ones is cold air. Cold air on the face is a very common trigger, so these sorts of triggers are one of the important things that a physician will look for when listening to some patient with presumed trigeminal neuralgia because the doctor is going to want to hear that there are triggers that set this off. If there are no triggers whatsoever, it doesn't mean that you can't have trigeminal neuralgia, but it does put the diagnosis not into doubt, but it does put a little bit of a question mark and the doctor's going to want to explore more things and get more history.
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