Trigeminal neuralgia
| Headline | |
|---|---|
| Etiology | dental causes, compression e.g. aneurysm, posterior fossa/extracranial tumours, cavernous sinus masses, dermoid/epidermoid/arachnoid cyst |
| Epidemiology | |
| Clinical presentation | episodic pain in trigeminal distribution (cheek/lower jaw) – “electric shock”, triggered by light/eating/talking/cold air may have autonomic symptoms Ddx: |
| Pathogenesis | |
| Diagnostic investigations | |
| Management | Complications: - Carbamazepine 100mg BD is 1st line → titrate. Breakthrough pain: modified release preparations • Counsel re SJS, N&V, ataxia, sedation, dizziness, ↓ Na - Intranasal lidocaine or topical lidocaine to trigger points e.g. gums can be considered! |
red flags
hearing/ear changes, skin/oral lesions (?perineural spread), bilat pain, optic neuritis, ~FHx MS, onset age <40
See CKS