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You see a 55 year old male with a 4 day history of ‘electric-shock’ like shooting pains in his right cheek. It seems to be provoked by eating and talking, but not on every occasion. He denies any limb weakness, facial drooping, or slurred speech. He has no dental problems. The pain is severe enough that he has had to take time off from his office job as he is unable to concentrate when it occurs.

Based on the most likely diagnosis, which of the following factors in his history would be least related?

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