Tag Archives: Neurology

Trigeminal Neuralgia

Trigeminal Neuralgia (Facial pain, tic douloureux)

  • Pain:  Paroxysmal stabbing pain affecting one or more divisions of the trigeminal nerve
  • rarely bilateral, and never on both sides at the same time
  • may last for days or weeks and patient may remain pain free for many months after pain subsides
  • Signs and symptoms:  usually no accompanying neurological problems, sometimes blunting of pinprick over affected region
  • Triggers: speaking, brushing teeth, washing face, eating, cold wind, touching a “trigger spot”
  • Mostly affects females and patients 50+ yrs of age

Investigation

  • CT or MR scan to exclude CPA lesion or demyelination

Acute Attack Treatment = Phenytoin 250 mg IV for relief for hours- 3 days

First line Agent =  Carbamazepine 100mg 1-2 times per day, with increase of 100-200mg every 3 days up to a maintenance dose of 400-800mg

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