A 58-year-old woman presents with severe, electric shock-like pain in the right V2 and V3 distributions lasting seconds, triggered by touching her cheek. There are no sensory deficits on examination. What is the first-line pharmacotherapy for this condition?
- A Amitriptyline
- B Gabapentin
- C Carbamazepine ✓
- D Phenytoin
Correct answer: C. Carbamazepine
Explanation
Carbamazepine is the first-line pharmacotherapy for classic trigeminal neuralgia, as recommended by standard texts like Harrison's. It reduces the frequency and severity of the electric shock-like pains by stabilizing hyperexcited neuronal membranes. Amitriptyline is the first-line agent for other neuropathic conditions such as postherpetic neuralgia, but it is not the primary choice for trigeminal neuralgia. Gabapentin is considered a second-line option.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.