General practice & primary care · UKMLA & AKT
Trigeminal neuralgia
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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