American Board of Internal Medicine (ABIM) Certification Practice Exam

Which symptom is often triggered by sensory stimulation in trigeminal neuralgia?

1. Dizziness

2. Nausea

3. Lancinating facial pain

4. Visual disturbances

The correct answer is: Lancinating facial pain

In trigeminal neuralgia, the hallmark symptom is lancinating facial pain, commonly described as sharp, shooting, or electric-like sensations. This discomfort is characteristically triggered by sensory stimuli such as light touch, chewing, speaking, or even a breeze against the face, which can easily provoke an episode of intense pain. The pain originates from irritation or dysfunction of the trigeminal nerve, which is responsible for sensation in the face. When that nerve is stimulated, whether through physical contact or certain environmental factors, it can lead to sudden, severe pain attacks that are typical of this condition. Understanding this mechanism is crucial for both diagnosis and management, as it informs both the clinician and patient of the behaviors and treatments that might help mitigate these episodes.