Trigeminal Neuralgia

Question 1

what is trigeminal neuralgia

Answer 1

chronic pain condition characterized by severe shooting or stabbing pain in the distribution of one or more divisions of the trigeminal nerve

Question 2

what can trigger trigeminal neuralgia

Answer 2

light touch, eating or wind blowing on the person’s face

Question 3

do patients with trigeminal neuralgia have normal neurological exams

Answer 3

yes

Question 4

presenting symptoms of trigeminal neuralgia

Answer 4

Sudden, unilateral, brief, stabbing pain in the distribution or one or more branches of the trigeminal nerve

Recurrent

Pain lasts from a few seconds to a couple of mins

Periods of remission can vary

Some experience preceding symptoms (e.g. numbness, tingling)

Pain is described as being ‘shock-like’

Question 5

causes of trigeminal neuralgia

Answer 5

Malignancy

Arteriovenous malformation

Multiple sclerosis

Sarcoidosis

Lyme disease

Question 6

MEDICAL management of trigeminal neuralgia

Answer 6

carbamazepine (first line)

phenytoin

lamotrigine

gabapentin

Question 7

SURGICAL management of trigeminal neuralgia

Answer 7

microvascular decompression

treatment of the underlying cause and alcohol injections