Trigeminal Neuralgia

Question 1

What is the definition of trigeminal neuralgia?

Answer 1

Neuralgia involving one or more of the branches of the trigeminal nerves, often causing severe pain.

Question 2

What is the aetiology of trigeminal neuralgia?

Answer 2

Thought to be due to compression of the trigeminal nerve by a loop of artery or vein

5-10% of cases are thought to be due to tumours, MS or skull base abnormalities

Question 3

What is the epidemiology of trigeminal neuralgia?

Answer 3

Peak incidence: 50-60 yrs

Prevalence increases with age

More common in FEMALES

Some familial component

Question 4

What are the signs and 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

What can trigger trigeminal neuralgia?

Answer 5

Vibration

Skin contact

Brushing teeth

Oral intake

Exposure to wind

Question 6

What are the appropriate investigations for trigeminal neuralgia?

Answer 6

Diagnosis is CLINICAL

If there is doubt over the underlying cause, specialists may request an MRI brain scan