Trigeminal neuralgia

Question 1

What is trigeminal neuralgia?

Answer 1

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

Question 2

Describe the aetiology of trigeminal neuralgia

Answer 2

Thought to be due to compression of the trigeminal nerve by a loop of artery or vein

Question 3

What pathologies may predispose to trigeminal neuralgia?

Answer 3

Tumours
MS
Skull base abnormalities

Question 4

Describe the epidemiology of trigeminal neuralgia

Answer 4

Peak incidence: 50-60 yrs
Prevalence increases with age
F > M
Some familial component

Question 5

Describe the pain experienced in trigeminal neuralgia

Answer 5

Sudden, unilateral, brief, stabbing pain in the distribution of one or more branches of the trigeminal nerve
Recurrent
Pain lasts s to mins
Periods of remission can vary
Some experience preceding Sx (e.g. numbness, tingling)
‘shock-like’

Question 6

List 5 triggers for trigeminal neuralgia

Answer 6

Vibration  
Skin contact  
Brushing teeth  
Oral intake 
Exposure to wind

Question 7

What investigations should be performed for trigeminal neuralgia?

Answer 7

Diagnosis is CLINICAL

If doubt over the underlying cause: MRI brain scan