Trigeminal neuralgia presentation

Post on 22-Dec-2014

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Transcript of Trigeminal neuralgia presentation

Submitted by:-

Anuradha Bds 3rd profRoll no 33

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DEPARTMENT OF ORAL

PATHOLOGY

Trigeminal neuralgia

CONTENTS1.TRIGEMINAL NERVE2.Definition Of trigeminal neuralgia3.Etiology4.Clinical features5.Differential diagnosis6.Laboratory findings7.Treatment

Trigeminal nerve

Trigeminal nerve is fifth cranial nerve.Trigeminal nerve is responsible for sensation in the face and certain motor function such as biting, chewing.Three major branches ophthalmic nerve, maxillary nerve, mandibular nerve

Definition:- Trigeminal neuralgia is a neuropathic disorder characterized by episodes of intense pain in the face, originating from the trigeminal nerve

synonyms:- 1.Tic doulourex, 2.trifacial neuralgia, 3.fothergill’s disease

Factors responsible for Trigeminal neuralgia

Compression of blood vessels, especially the superior cerebellar artery occurs

Chronic irritation of trigeminal nerve at the root entry

zone

Increased firing of the afferent or sensory fibres  Trigeminal neuralgia

AETIOLOGY

Clinical features

Affected :Older > young

>

Females > males3:2

>

nerve Involvement :

maxillary-60%mandibular-49%ophthalmic-16%all 3 divisions-

1%

Right side > left side 1.7 : 1

painUnilateral painEarly pain or pretrigeminal neuralgia :-dull,aching,burning.Pain lasts for few seconds to a minute.Aggravates and suffererhave attempted suicide.

Trigger zones

Differential diagnosis 1. MIGRAINE2.SINUSITIUS3.COSTEN SYNDROME4.TRIGEMINAL NEUROPATHY5.TROTTER’S SYNDROME6.POST HERPETIC NEURALGIA

MIGRAINE sinusitis

Trotter’s syndrome

POST HERPETIC NEURALGIA

Trigeminal neuropathy

Costen

syndrome

Laboratory findings

Elective MRI

Treatment1.PERIPHERAL NEURECTOMY2.MEDICINE :- a. PHENYTOIN (DILANTIN)b . CARBAMAZEPINE (TEGRETOL)3.MICROSURGICAL DECOMPRESSION OF TRIGEMINAL ROOT4.Injection of boiling water in gasserian ganglion

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