Trigeminal Neuralgia

Question 1

Definition

Answer 1

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

Question 2

Aetiology

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

Epidemiology

Answer 3

• Peak incidence: 50-60 yrs
• Prevalence increases with age
• More common in FEMALES
• Some familial component

Question 4

Presenting symptoms and signs on physical examination

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

Triggers

Answer 5

o Vibration
o Skin contact
o Brushing teeth
o Oral intake
o Exposure to wind

Question 6

Investigations

Answer 6

• Diagnosis is CLINICAL

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