Trigeminal neuralgia
Brief electric-shock facial pain in V2 or V3, MRI for every patient, carbamazepine first with HLA testing where relevant, and when to refer for microvascular decompression.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Unilateral, paroxysmal, electric-shock facial pain lasting seconds, triggered by light touch, talking, eating, brushing teeth or a breeze.
- Usually V2 or V3, more often in women and after 50.
- Examination is normal in classical and idiopathic disease. Sensory loss means look for a secondary cause.
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Sources
- Therapeutic Guidelines: Neurology (trigeminal neuralgia)AU/NZTherapeutic Guidelines Limited (eTG complete), current eTG edition (version not verified)
- Tegretol (carbamazepine) Australian Product Information, section 4.4 (HLA-B*1502 and HLA-A*3101)AU/NZmedsinfo.com.au (sponsor Product Information), September 2026
- European Academy of Neurology guideline on trigeminal neuralgia (Bendtsen L et al. Eur J Neurol 2019;26:831-849)European Academy of Neurology, 2019 (no later revision found, November 2026)
- The International Classification of Headache Disorders, 3rd edition (ICHD-3), 13.1 Trigeminal neuralgiaInternational Headache Society (Cephalalgia), 2018
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy