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PLAB02-164

Jenny is a 51 year old fitness instructor and presents with episodic pains in her face that are described as shooting and tingling which last a few seconds. These are provoked by eating and cold air. A diagnosis of Trigeminal Neuralgia is suspected.

Which one of the following co-existing factors would be an appropriate reason for secondary care referral to see if there is a serious underlying cause?

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