Trigeminal Neuralgia

Characterised by an unilateral, sharp, stabbing and intermittent pain in division of the trigeminal nerve but no sensory loss. Diagnosed by relief following nerve block using bupivacaine 0.5%.

Treatment

Carbamazepine 100-200mg oral once or bd

Dose can be increased to 400-600mg and even up to 1.2g/day.

Bell’s Palsy

Acute unilateral, lower motor neurone type of facial palsy of unknown aetiology (maybe viral). Most recover spontaneously.

It is advisable to protect the eye with pad or artificial tears to prevent corneal damage when eyelids cannot close properly.

Steroids are of unproven value but still, certain authorities advise giving oral prednisolone 5-10mg bd for 5 days, early during the disease to aid recovery.