Trigeminal Neuralgia — MFDS Part 1 MCQ
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Correct answer: E — Recurrent unilateral electric-shock-like facial pain lasting seconds to minutes, often precipitated by light touch
Explanation lettering: D = shown as A · E = shown as D · A = shown as E
A is correct. Trigeminal neuralgia characteristically causes recurrent, severe, unilateral, electric-shock-like pain within one or more trigeminal divisions. Individual paroxysms usually last seconds to minutes and are often precipitated by innocuous stimuli such as light touch, talking, chewing or toothbrushing, although spontaneous attacks can occur. Option B is more consistent with temporomandibular disorder. Option C describes a trigeminal autonomic cephalalgia, such as cluster headache, because of the longer orbital attacks and prominent cranial autonomic features. Prolonged throbbing nocturnal pain in D is not the characteristic temporal pattern. Progressive objective numbness, as in E, is a neurological red flag suggesting trigeminal neuropathy or a structural lesion rather than uncomplicated trigeminal neuralgia.
Reference: University Hospitals Birmingham NHS Foundation Trust. Trigeminal Neuralgia (TGN) pathway, section 'You suspect the patient has TGN'. Last reviewed 3 April 2025. https://www.uhb.nhs.uk/gps/referrals/referrals-by-specialty/neurology/trigeminal-neuralgia-tgn-pathway/