BOF 46
A 55 year old woman came to see you complaining of
severe episodic facial pain, you diagnosed trigeminal neuralgia, all of the
followings are wrong about her illness, except:
1-pain usually lasts for many hours
2-there is absent corneal reflex
3-the illness is usually seen in young males
4-the response is usually favourable to
anticonvulsants
5-when bilateral or alternating, this excludes
multiple sclerosis
Answer 4
1-the patients usually describes the pain as if it is
of many hours duration, actually speaking , it is lancinating in seconds only
but the rapid repetition of many episodes with in a short period gives a false
impression of many hours duration
2-the neurological examination, apart from certain
triggering ZONES, should be normal.
3-usually middle aged and elderly females
4-true, carbamazepine is very effective
5-MS must be excluded here
Revision Tip
Revise
causes of headache ACES for PACES page 458
