Trigeminal Neuralgia Flashcards
What is the typical history associated with trigeminal neuralgia?
Recurrent, sudden, severe, stabbing pain in the distribution of the trigeminal nerve. Pain episodes last from a few seconds to minutes. Triggered by activities such as chewing, speaking, or touching the face.
What are the key physical examination findings in trigeminal neuralgia?
Normal neurological examination between attacks. Possible trigger zones on the face that provoke pain when stimulated.
What investigations are necessary for diagnosing trigeminal neuralgia?
Clinical diagnosis based on history and symptoms. MRI to rule out secondary causes such as tumors or multiple sclerosis.
What are the non-pharmacological management strategies for trigeminal neuralgia?
Avoidance of known triggers. Stress management techniques. Educate on the chronic nature of the condition.
What are the pharmacological management options for trigeminal neuralgia?
Carbamazepine as first-line treatment. Alternative medications: oxcarbazepine, gabapentin, baclofen. Surgical options for refractory cases.
What are the red flags to look for in trigeminal neuralgia patients?
Persistent or worsening pain despite treatment. Neurological deficits: numbness, weakness. Signs of secondary causes such as tumors.
When should a patient with trigeminal neuralgia be referred to a specialist?
Refractory trigeminal neuralgia not responding to medication. Consideration for surgical interventions. Need for advanced diagnostic testing.
What is one key piece of pathophysiology related to trigeminal neuralgia?
Compression of the trigeminal nerve root by a blood vessel or tumor. Leads to demyelination and abnormal electrical activity in the nerve. Results in severe facial pain.
