Trigeminal Neuralgia

Question 1

How does the International Headache Society define trigeminal neuralgia?

Answer 1

1. A unilateral disorder characterised by brief electric shock-like pains, abrupt in onset and termination, limited to one or more divisions of the trigeminal nerve
2. The pain is commonly evoked by light touch, including washing, shaving, smoking, talking, and brushing the teeth (trigger factors), and frequently occurs spontaneously
3. Small areas in the nasolabial fold or chin may be particularly susceptible to the precipitation of pain (trigger areas)
4. The pains usually remit for variable periods

Question 2

What are the causes of trigeminal neuralgia?

Answer 2

• Idiopathic (Most common)
• Tumours
• Vascular problems.

Question 3

What is the management of trigeminal neuralgia?

Answer 3

• First line: Carbemazepine
• If fails or atypical features or <50 years old then refer to neurology