Trigeminal Neuralgia Second-Line — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

HardPain MedicineTrigeminal Neuralgia Second-LineFRCA Final

Trigeminal neuralgia V2 distribution: carbamazepine and oxcarbazepine failed (hyponatraemia). Next pharmacological treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Lamotrigine

TN: carbamazepine first-line (NICE specifically for TN). Oxcarbazepine alternative. Both failed/hyponatraemia: lamotrigine has best evidence from small RCTs. Refer for neurosurgical assessment after 2 failed drugs.

Reference: NICE – 2023 – CG173; AAN – 2023 – TN guideline