TRIGEMINAL NEURALGIA

SMRGU.23 Nov.2013

FACIAL PAIN

Presents along side with headache

PATIENT ASSESMENT WITH FACIAL PAIN

age

SEX PREVALENCE

High Risk Group Low Risk group

Cont.

Localisation could be unilateral OR

Localisation could be• Bilateral

OTHERS

Class A• Quality : throbbing, sharp• Trigger zone: touch the site

where the originate (nerve root identificattion )

Class b• Frequency : can be constantOr paroxysmal remission.

CAUSES

1.Trigeminal nerve compression2.Headache3.Toothache

4.Sinusitis5.Injury to the face .6.Temeperomandibular joint dysfunction.

TRIGEMINAL NEURALGIA

SUCIDE DISEASE

TYPES OF PAIN

1.NOCICEPTIVE 2.NON NOCICEPTIVE (NEUROPATHIC PAIN) Neuropathic pain is divide into * Trigrminal neuralgia*Postherpetic neuralgia

THIS IS TRIGEMINAL NEURALGIA !!!!

UNDERLINE CAUSES

TUMORS

TRAUMATIC DAMAGE

SYMPTOMS OF TRIGEMINAL NEURALGIA1.INTERMITTENT TWINGES OF MILD PAIN2.SEVERE EPISODE OF SEARING,SHOOTING,JABBING PAIN THAT FEELS LIKE ELECTRIC SHOCK

3.UNILATERAL PAIN.TINGLING AND NUMBNESS OF THE FACE.

AREAS OF PAIN

CLASSIFICATION OF TRN

TYPICAL TIGEMINAL NEURALGIA

• PAIN IS SHARP,THROBBING,AND ELECTEIC SHOCK LIKE

..THERE IS NO WEAKNESS OR FACIAL NUMBESS

ATYPICAL TRIGEMINAL NEURALGIA

• BURNING PAIN,ACHING PAIN, CRAMPING PAIN.

• IT EXTEND TO THE REGION OF THE NECK.

• IT IS HARDER TO DIAGNOSE PEOPLE WITH ATYPICAL TRN

DIAGNOSIS

MRI

PHARMACOLOGICAL APPROACH TO TRIGEMINAL NEURALGIA

ANTI CONVULSANT :TEGRETOL,CARBATROL. SOMETIMES GABAPENTINE IS USED.

Side effect include: dizziness , confusion , drowsiness ,vision problem e.t.c sucidal thoughts.

ANTISPASTICITY AGENTS : BACLOFEN EITHER INDEPENDENTLY OR IN COMBINATION WITH CARBAMAZEPINE OR PHENYTOIN .

ALCOHOL INJECTION : CAUSES NUMBING EFFECT

SURGICAL APPROACH TO TRIGEMINALNEURALGIA

GOALS OF SURGEON DURING SURGERY

1.DECOMPRESSION OR 2 SEVERING OF THE NERVE

SURGICAL APPROACH

1.MICROVASCULAR DECOMPRESSION SURGERY (MVD)2.PERCUTANEOUS GLYCEROL RHIZOTOMY (PGR)3.PERCUTANEOUS BALLON COMPRESSION OF TRIGEMINAL NERVE (PBCTN)4.PERCUTANEOUS STEREOSTATIC RADIOFREQUENCY THERMAL RHIZOTOMY (PSRTR)5.PARTIAL SENSORY RHIZOTOMY6.GAMMA KNIFE RADIOSURGERY

MVD

PREVENTION

There are no guildlines for preventin g the development of trigeminal neuralgia,butYou can only take steps to prevent the attack.

TIPS TO AVIOD ATTACKS

1.EAT LUKEWARM FOODS AND DRINKS2.EAT SOFT FOOD3.AVIOD KNOWN TRIGGERS.4.USE COTTON PADS WHEN WASHING YOUR FACE.

WELCOME TO,OUTSIDE THE BOX THOUGHT PROCESS1901

2 CONCLUSIONS

1904