What can often accompany the severe pain episodes in patients with trigeminal neuralgia?

Severe pain episodes in patients with trigeminal neuralgia are frequently accompanied by muscle spasms. This association is due to the intense and sudden nature of the facial pain, which can lead to secondary muscle contractions or spasms in the jaw or facial muscles as a response to the acute pain experienced. The body's natural reaction to pain can involve involuntary muscle tightening, which causes discomfort and further complicates the patient's experience.

The other options do not typically correlate with trigeminal neuralgia pain episodes. Palpitations and extreme fatigue are not direct consequences of the localized facial pain experienced during an episode. Vision changes may occur in some neurological conditions but are not commonly associated with trigeminal neuralgia. The hallmark feature of this condition is the episodes of severe, sharp facial pain, and muscle spasms are a more direct manifestation of the body's response to that pain.