Carbamazepine Trigeminal Neuralgia — MFDS Part 1 MCQ

Correct answer: B — Carbamazepine

Carbamazepine is the correct answer. The brief, unilateral, electric-shock-like attacks precipitated by light touch are characteristic of trigeminal neuralgia, and the absence of an odontogenic cause helps exclude dental infection. Carbamazepine is an anticonvulsant and is the usual initial pharmacological treatment; it is also licensed in the UK for the paroxysmal pain of trigeminal neuralgia. The dose is introduced and increased gradually. Dizziness, drowsiness and ataxia are common adverse effects, while serious cutaneous and haematological reactions require appropriate counselling and monitoring. Ibuprofen and paracetamol generally do not control this neuropathic paroxysmal pain. Amoxicillin and metronidazole treat susceptible bacterial infections and have no role when there is no odontogenic infection.

Reference: NHS, Trigeminal neuralgia — Treatment, page last reviewed 27 January 2023. https://www.nhs.uk/conditions/trigeminal-neuralgia/treatment/