55-year-old woman with severe right facial pain — sharp, electric shock-like, lasting seconds, triggered by brushing, talking, or light touch. No dental pathology. First-line treatment?

Correct answer: C. Carbamazepine

• A. NSAIDs like ibuprofen are not effective first-line therapy for the neuropathic pain of trigeminal neuralgia.
• B. There is no infectious/dental pathology described here, so antibiotics are inappropriate.
• C. Correct. Carbamazepine is the first-line pharmacologic treatment for trigeminal neuralgia, an anticonvulsant that stabilizes nerve membranes and reduces neuropathic pain episodes.
• D. Acetaminophen is not effective for the neuropathic, electric-shock-type pain of trigeminal neuralgia.