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Low Vitamin B12 Syndrome in Trigeminal Neuralgia

Arun Aggarwal and Irene Wood

Trigeminal neuralgia (tic douloureux) is a disorder of the fifth cranial (trigeminal) nerve that causes episodes of intense, stabbing, electric shock-like pain in the areas of the face where the branches of the nerve are distributed - lips, eyes, nose, scalp, forehead, upper jaw, and lower jaw. The International Association for the Study of Pain (IASP) defines trigeminal neuralgia as a sudden, usually unilateral, severe, brief, stabbing, recurrent pain in the distribution of one or more branches of the fifth cranial nerve. Typically, brief attacks of pain are triggered by talking, chewing, brushing teeth, and shaving, applying make-up or even a slight breeze. Generally, it is a clinical diagnosis, although imaging may be necessary to exclude other pathology.