Trigeminal Neuralgia

Exam Cram

• Trigeminal neuralgia is caused by inflammation of the trigeminal nerve

• Presentation: sharp shooting pains, lasting seconds- starting at ear and moving across face, worse with cold air or brushing hair

• Investigation: MRI- rule out malignancy (cerebellar pontine or cavernous sinus lesion)

• Management: carbamazepine

Diagnosis

IHS Diagnostic criteria

• Pain occurs in one or more division of the trigeminal nerve, with no radiation beyond this distribution

• Characteristics 3/4: 

  1. Paroxysmal, lasting less than 2 mins

  2. Severe

  3. Electric shock, shooting, stabbing or sharp

  4. Triggered by facial stimulus (e.g. toothbrushing)

• Three or more attacks fulfilling criteria above

• Nil Clinical neurological deficit

References and Resources

Written 2024.