Trigeminal neuralgia

Question 1

What- trigeminal neuralgia?

Answer 1

Long term pain disorder that affects the trigeminal nerve

Trigeminal nerve:
V1- ophthalmic
V2- maxillary
V3- mandibular

Secondary headache

Question 2

who more commonly affected- trigeminal neuralgia?

Answer 2

> 60s
Women
5-10% people with MS

Question 3

cause - Trigeminal neuralgia?

Answer 3

Cause is unclear but it is thought to be caused by compression of the nerve

Question 4

triggers- trigeminal neuralgia?

Answer 4

Usually triggered by touch to one of the trigeminal zones:
Washing
Shaving
Cold wind
Chewing

Question 5

What branches of the trigeminal nerve are most often affected in trigeminal neuralgia?

Answer 5

V2/V3

Question 6

presentation- trigeminal neuralgia?

Answer 6

90% unilateral
Severe stabbing unilateral pain (electric shooting pain)
1- 90 seconds
10 to 100 a day
Bouts of pain may last from a few weeks to months before spontaneous remission

Question 7

pharmacological treatment- trigeminal neuralgia?

Answer 7

Carbamazepine= first line
Gabapentin
Phenytoin
Baclofen

Question 8

Surgical treatment - trigeminal neuralgia?

Answer 8

Ablation, decompression

Question 9

A 50-year-old man presents to his General Practitioner with recurrent facial pains. He describes these as sharp pains across his left jaw. These are triggered by cold winds and shaving. What is the most likely diagnosis?

Answer 9

trigeminal neuralgia

Question 10

A 32 year old patient with a history of depression presents with four episodes of severe shooting pain on her right cheek. Cranial nerve examination is normal, but the patient complains of worsening pain on light touch in the same area.

What is the most appropriate first line treatment for this patient?

Answer 10

carbamazepine