neuro trigeminal neuralgia

Question 1

what are the different types of trigeminal neuralgia

Answer 1

classical, idiopathic and secondary

Question 2

what is classical trigeminal neuralgia

Answer 2

neurovascular compression of the trigeminal nerve root most often by loop of a neighbouring artery most commonly superior cerebellar artery

Question 3

what is secondary trigeminal neuralgia

Answer 3

caused by major underlying neurological disease for eg ms, a tumor at cerebellopontine angle and av malformation

Question 4

clinical features of trigeminal neuralgia

Answer 4

unilateral face pain, severe stabbing pain following burning ache, lasts several seconds and can occur up to 100 times per day, pain shoots from mouth to angle of jaw on the affected side, can occur at rest, while talking or touch like while brushing teeth

facial spasm may occur

Question 5

how is trigeminal neuralgia diagnosed

Answer 5

clinically

Question 6

what is the imagining modality best to test for trigeminal neuralgia

Answer 6

mri head without and with iv contrast and mra

Question 7

what class of drugs are the mainstay of treatment in classical trigeminal neuralgia and idiopathic

Answer 7

anticonvulsants

Question 8

first line medical drugs in treating trigeminal neuralgia

Answer 8

carbimazole, oxcarbamazine

Question 9

tx for acute exaccerbation of trigeminal neuralgia

Answer 9

lidocaine infusion

further treatment: phenytoin infusion , oral and nasal application of lidocaine…opiods not usually effective

Question 10

surgical management of trigeminal neuralgia should medical fail

Answer 10

microvascular decompression