MS – Secondary Trigeminal Neuralgia — SCE Neurology MCQ

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ModerateMultiple Sclerosis & CNS InflammationMS – Secondary Trigeminal NeuralgiaSCE Neurology

A 45-year-old woman with MS develops bilateral trigeminal neuralgia. MRI shows a demyelinating plaque at the trigeminal root entry zone. What is the first-line pharmacological treatment?

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Correct answer: E — Carbamazepine

Explanation lettering: D = shown as B · E = shown as C · C = shown as D · B = shown as E

Secondary TN in MS is treated with carbamazepine, the same first-line as classical TN. Oxcarbazepine is an alternative. A: Gabapentin is not first-line for TN. C: Amitriptyline is for neuropathic pain broadly. D/E: Not first-line for TN.

Reference: NICE CG150 (2012); ABN TN Guidelines