Trigeminal Neuralgia

Question 1

What is the definition of trigeminal neuralgia?

Answer 1

Long term pain disorder affecting trigeminal nerve.

Question 2

What can trigger trigeminal neuralgia attacks?

Answer 2

Stimulation of the face:
- Washing
- Shaving
- Cold wind

Question 3

What is the pathophysiology of trigeminal neuralgia?

Answer 3

Unclear but thought to be compression of trigeminal nerve

Question 4

What are some clinical features of trigeminal neuralgia?

Answer 4

Severe unilateral stabbing facial pain
Lasts 1-90 seconds
Multiple attacks in a day with refractory period after each
Bouts of pain lasting weeks-months with spontaneous remission lasting months or years before recurrence

Question 5

What are some investigations for trigeminal neuralgia?

Answer 5

MRI brain

Question 6

What is the management of trigeminal neuralgia?

Answer 6

Medical:
- Carbamazepine (1st line)
- Gabapentin
- Phenytoin

Surgical:
- Ablation
- Decompression