⚕️ FREE MSRA PODCAST – Trigeminal Neuralgia
🎧 A clear, high-yield breakdown of this chronic facial nerve pain disorder – perfect for exam prep and real-life clinical scenarios.

🧠 Key Learning Points

📌 Definition
• A chronic pain condition affecting the trigeminal nerve (CN V), causing severe, electric shock-like facial pain.

📌 Causes & Risk Factors
• Vascular compression (most common – e.g., superior cerebellar artery)
• Multiple sclerosis (especially in younger patients)
• Tumours or cysts compressing the nerve
• Risk ↑ with age >50, female sex, MS, family history
💡 Mnemonic: “COMPress” – Compression, Old age, MS, Pseudotumour (mass)

📌 Pathophysiology
• Demyelination or irritation of trigeminal nerve → ectopic firing → paroxysmal neuropathic pain
• Often linked to abnormal sodium channel activity

📌 Symptoms
• Unilateral, sudden, sharp/stabbing or electric-shock pain
• Lasts seconds to minutes
• Triggered by touch, chewing, talking, brushing teeth
💡 Mnemonic: “UP STAIRs” – Unilateral, Paroxysmal, Shock-like, Triggered, Activities, Intense, Recurrent

📌 Differential Diagnosis
• Cluster headache
• Migraine
• Dental pain
• Glossopharyngeal neuralgia
• Temporal arteritis
• Tumours or demyelination (e.g., MS)

📌 Diagnosis
• Clinical diagnosis based on classic presentation
• MRI if red flags: age <40, bilateral pain, forehead-only pain, sensory loss, optic neuritis
💡 MRI rules out secondary causes like tumours, MS plaques, or vascular loops

📌 Management
• 🥇 First-line: Carbamazepine
• Alternatives: gabapentin, lamotrigine, phenytoin, baclofen
• Refractory: Microvascular decompression (MVD), radiofrequency ablation, gamma knife
• Support: Multidisciplinary input, psychosocial care
❌ Paracetamol, NSAIDs, opioids are not effective

📌 Complications
• Side effects from antiepileptics (e.g., dizziness, hyponatraemia)
• Surgical risks (e.g., facial numbness, deafness)
• Severe impact on quality of life and mental health

📌 Prognosis
• Often chronic and recurrent
• Good symptom control with early and appropriate treatment
• Some achieve long-term relief, especially post-surgery

📎 More MSRA Resources for Trigeminal Neuralgia

📝 Revision Notes: https://www.passthemsra.com/topic/trigeminal-neuralgia-revision-notes/
🧠 Flashcards: https://www.passthemsra.com/topic/trigeminal-neuralgia-flashcards/
💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/trigeminal-neuralgia-accordion-qa-notes-2/
🚀 Rapid Quiz: https://www.passthemsra.com/topic/trigeminal-neuralgia-rapid-quiz/
🎓 Full Course: https://www.passthemsra.com/courses/neurology-for-the-msra/

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