Free BCEN Certified Emergency Nurse (CEN) Practice Question

Carbamazepine is the first-line treatment for trigeminal neuralgia. This condition is characterized by paroxysmal attacks of severe, electric shock-like pain in the distribution of one or more branches of the trigeminal nerve, often triggered by innocuous stimuli. The absence of facial weakness or numbness helps differentiate it from other conditions like Bell's palsy.

While MRI is important to rule out secondary causes (e.g., tumors, multiple sclerosis), it's not the immediate next step in management. Immediate pain relief is crucial, and carbamazepine can provide this while further workup is planned.

Opioids are generally ineffective for trigeminal neuralgia and carry risks of dependence. Acyclovir is used for herpes zoster, which can cause facial pain but typically presents with a rash. Botulinum toxin injections are sometimes used for refractory cases but are not first-line therapy.

It's important to note that while initiating treatment, further diagnostic workup should be planned to rule out secondary causes of trigeminal neuralgia.