Trigeminal Neuralgia

Question 1

Define Trigeminal Neuralgia

Answer 1

Facial pain syndrome in the distribution of >1 divisions of the trigeminal nerve

Question 2

Aetiology of trigeminal neuralgia

Answer 2

Associated with trigeminal nerve compression (80-90%) by an aberrant vascular loop (typically superior cerebellar artery)

Demyelinating disease (20x more prevalent in MS sufferers)

Brainstem infarcts and amyloid/calcium deposition

Question 3

Risk factors for trigeminal neuralgia

Answer 3

Increased Age
Multiple sclerosis
Female
HTN

Question 4

Symptoms of trigemintal neuralgia

Answer 4

Facial pain (restricted to the trigeminal nerve dermatomes | Bilateral | stabbing pain

Sensory changes

Preceded by oropharyngeal/facial trauma or herpetic outbreak

Question 5

Investigations for trigeminal neuralgia

Answer 5

CLINICAL diagnosis

Intra oral XR to rule out dental cause
MRI to demonstrate abnormal vessel loop
Trigeminal reflex testing - early blink reflex or early master inhibitory reflex