Trigeminal Neuralgia

Question 1

Define Trigeminal Neuralgia?

Answer 1

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

Question 2

What is the aetiology of Trigeminal Neuralgia?

Answer 2

Thought to be due to compression of the trigeminal nerve by a loop or artery or vein
5-10% of cases are thought to be due to tumours, MS or skull base abnormalities

Question 3

What is the epidemiology of Trigeminal Neuralgia?

Answer 3

Peak Incidence: 50-60 yrs
Prevalence increases with age
More common in FEMALES
Some familial component

Question 4

What are the presenting symptoms and signs of Trigeminal Neuralgia?

Answer 4

Sudden, unilateral, brief, stabbing pain in the distribution or one or mroe branches of the trigeminal nerve
Recurrent
Pain lasts from a few seocnds to a couple of mins
Periods of remission can vary
Some experience preceding symptoms (e.g. numbness, tingling)
Pain is described as being ‘shock-like’

Question 5

What are the triggers of Trigeminal Neuralgia?

Answer 5

Vibration
Skin contact 
Brushing teeth 
Oral intake 
Exposure to wind

Question 6

What investigations do we do for Trigeminal Neuralgia?

Answer 6

Diagnosis is clinical

If there is doubt over the underlying cause, specialists may request an MRI brain scan