Quiz Form

Question Date: 21/09/2023

Question: Which statement is not true regarding trigeminal neuralgia?

Options:

• 50% of patients will report a trigger
• Neurovascular compression may occur without symptoms
• Familial cases may be seen in 11%
• The highest probability of pain relief is with microvascular decompression

Correct Answer: 50% of patients will report a trigger

Explaination: Almost 99% of patients report a trigger with provocation of pain by an innocuous trigger like touch, chewing etc. Patients may have a refractory period where repeated stimulation may fail to induce the pain. Neurovascular compression in the root entry zone- a few millimeters before it enters the pons is the accepted pathology, but a study showed neurovascular compression without symptoms in normal individuals. Familial cases have been seen in 10%, some with hereditary neuropathy such as Charcot-Marie-Tooth disease or mutation in Nav1.6, they have earlier onset and other associated neuralgias. Microvascular decompression in the presence of a vascular loop provides the highest relief of 70-88%

Reference: Robertson C. Cranial Neuralgias. Continuum 2021 27(3 Headache)665-685.