Trigeminal Neuralgia
Brief description of the condition
Severe facial pain in the distribution of the trigeminal nerve, usually unilateral (i.e. only one side of the face). The duration of acute episodes is short lived.
Key signs and symptoms
- Pain (severe, stabbing, lancinating and shooting pain, often triggered by touching certain areas of the face)
- Brief facial spasm or tic
Initial management
Prescribe carbamazepine (see SDCEP ‘Drug Prescribing for Dentistry’ guidance for dose) without delay.
Recommend optimal analgesia (see Appendix 2).
Consider use of a long-acting local anaesthetic block in the affected area.
Advise the patient to seek emergency medical care.
Subsequent care
Monitor symptoms and response to medication at follow-up appointments and titrate the dose.
Monitor for adverse effects by ordering a full blood count and liver function tests.
If unresponsive or intolerant of drug therapy, refer to a specialist for further assessment.