La NT se manifiesta en forma de crisis paroxísticas de dolor facial con una duración desde segundos a dos minutos. El dolor se manifiesta en una o varias de las ramas trigeminales, oftálmica, maxilar y mandibular. Se describe como un dolor repentino, intenso, superficial y punzante o quemante. Puede desencadenarse por la estimulación de zonas gatillo ante estímulos táctiles o térmicos (zona cutánea, gingival, labial) o al masticar, hablar, comer, sonreír o bostezar.
En los periodos entre crisis el paciente está asintomático. Las crisis de dolor son estereotipadas en cada paciente.
Motivo de sospecha de causa secundaria y derivación podrían ser: edad <50 años (o 40 años, según fuentes), dolor bilateral, contínuo, sin puntos gatillo, déficit neurológico, mala respuesta a tratamiento.
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