Medical MCQ - A 61-year-old female patient presents to your clinic due to sudden episodes of left-sided facial pain for the last two days. She states that the pain feels like a 'sharp stabbing ' and is a 9/10 in terms of intensity. The pain lasts about 5-10 seconds and then dissipates rapidly. The pain is often brought on by talking and cold wind. Her past medical history is significant for depression and type 2 DM. What is the diagnosis?

A 61-year-old female patient presents to your clinic due to sudden episodes of left-sided facial pain for the last two days. She states that the pain feels like a ‘sharp stabbing ‘ and is a 9/10 in terms of intensity. The pain lasts about 5-10 seconds and then dissipates rapidly. The pain is often brought on by talking and cold wind. Her past medical history is significant for depression and type 2 DM. What is the diagnosis?

Giant cell aeritis

SUNCT syndrome

Trigeminal neuralgia

paroxysmal hemicrania

Question Category:

Medicine

Correct Answer:

Trigeminal neuralgia

Description:

Option A- Ruled out as it presents with jaw claudication or U/L headache or temporal headache. Option B- Ruled out as It is associated with conjunctival injection and tearing, so RED eye should be present in the question. Option D -Paroxysmal Hemicrania-ruled out Throbbing and stabbing pain at temporal and orbit area Duration 2-30 min No alcohol or cutaneous trigger Have autonomic and migrainous features Respond well to Indomethacin. Trigeminal Neuralgia: Excruciating pain in lips, gums, cheeks or chin. Occurs spontaneously or with chewing, speaking or smiling. Presence of trigger zone (face, lips, tongue) Provoked by cold wind, brushing or washing face. Female> male Onset- Sudden, persist for weeks to months and remit spontaneously.

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