Trigeminal Neuralgia (1) Flashcards
How does it present?
What are some triggers?
What are the causes of it?
➊ • Sudden, severe, electricity-like shooting facial pain - Lasts few seconds in trigeminal nerve distribution (jaw, teeth or gums)
• Causes pts face to screw up = Tic Douloureux
➋ Washing face, Shaving, Eating, Talking, Brushing teeth
➌ Vascular compression of trigeminal nerve, MS
How is it investigated?
How is it managed conservatively?
How is it managed medically?
How is it managed surgically?
➊ • Exclude differentials – Migraine, GCA, MSK pain
• MRI – Find possible cause and rule out other secondary causes
➋ Avoid triggers
➌ • 1st line is Carbamazepine – Anticonvulsant that helps slows down nerve impulses to relieve pain
‣ Started on 100mg TDS, and then titrated up by 100-200mg every 2 wks until pain is relieved
• 2nd line – Oxcarbazepine, Lamotrigine, Baclofen (antispasmodic)
➍ Microvascular decompression – Blood vessel kept separate from trigeminal nerve to relieve the pressure
