Trigeminal Neuralgia

Question 1

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 1

Trigeminal Neuralgia

Question 2

A 35-year-old man is referred to the neurology clinic due to attacks of shooting pain on the right side of his lower face. The episodes usually happen after eating or shaving.

On examination, there is mild sensitivity on the right side of his face. Otherwise, no neurological deficits are noted.

What is the most appropriate treatment for this patient?

Answer 2

Carbamazepine

This patient likely has trigeminal neuralgia. The first line treatment is carbamazepine with a starting dose of 100 mg up to twice daily, which can be titrated up in steps of 100-200mg every two weeks until the pain has been relieved.

Question 3

Treatment of Trigeminal Neuralgia

Answer 3

b The first line treatment is carbamazepine with a starting dose of 100 mg up to twice daily, which can be titrated up in steps of 100-200mg every two weeks until the pain has been relieved.