Condition- Trigeminal Neuralgia

Question 1

What is trigeminal neuralgia?

Answer 1

A facial pain syndrome causing episodes of sharp, stabbing pain in 1 or more branches of the trigeminal nerve (usually mandibular/ maxillary)

Question 2

What is thought to be the cause of trigeminal neuralgia?

Answer 2

• Compression of root of a trigeminal nerve by intracranial vessels

Question 3

List some secondary causes of trigeminal neuralgia

Answer 3

Compression by:

• Tumours
• Aneurysms
• Meningeal infection
• MS
• Zoster
• Skull base malformation

Question 4

Which gender and age group is most at risk of Trigeminal Neuralgia

Answer 4

Elderly (>75)

Females

Question 5

Describe the presenting symptoms of Trigeminal Neuralgia (go through SOCRATES)

Answer 5

• S: UNILATERAL, branch of CNV - most commonly mandibular (jaw pain), maxilllary (cheek pain), least commonly opthalmic (headache)
• O: Sudden, brief, few seconds to a couple of mins
• C: intense, stabbing pain
• R: sometimes pain may be felt on contralateral side too
• A: Numbness/ tingling precede
• T: recurrent
• E: Triggers:
  
  • Vibration
  • Skin contact- washing area, shaving
  • Eating
  • Talking
  • Brushing teeth
  • Wind
• S: shock-like (makes you screw up face)

Question 6

Which investigations could you order to identify Trigeminal Neuralgia?

Answer 6

• CLINICAL DIAGNOSIS
• MRI + Intra oral x-ray: to rule out other causes of facial pain