General practice & prim · UKMLA & AKT
Trigeminal neuralgia
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise trigeminal neuralgia — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Electric shock-like pain - sudden, severe, unilateral, stabbing/lancinating; described as 'like an electric shock'
- Paroxysmal - attacks last seconds to two minutes, then resolve completely
- Unilateral - V2 (maxillary) and V3 (mandibular) most commonly affected; isolated V1 is uncommon
- Trigger factors - light touch, eating, talking, brushing teeth, shaving, cold wind
- Pain-free intervals - patient entirely well between attacks
- Normal neurological examination in classical trigeminal neuralgia - any sensory deficit or cranial nerve sign suggests a secondary cause
Bilateral trigeminal neuralgia should always prompt consideration of multiple sclerosis - classical idiopathic trigeminal neuralgia is almost invariably unilateral. TN is 20 times more common in MS patients.
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