2. Trigeminal neuralgia &
its management
• Definition
• It is defined as sudden, usually
unilateral , severe , brief , lancinating
& recurring pain in distribution of one
or more branches of 5th cranial
nerve
2
3. Cont.
• Clinical features
• Paroxysmal sharp& lancinating pain
involving maxillary & mandibular
divisions of nerve
• Ophthalmic division of the nerve is
unaffected
3
4. Cont.
• Painful attacks may occur in succession
• Stimulation of ‘ trigger zones’ initiate
attack
• Trigger zones are
– Near ala of the nose
– Near corners of the mouth
– Gingiva
4
5. Cont.
• Paroxysms may last for several days
or weeks
• Pt will have a motionless face -frozen
or mask like face
• Male pt avoid shaving & oral hygiene
is poor , as pt avoids brushing of
teeth
5
6. Cont.
• Treatment
• Carbamazepine , 200 mg thrice daily
• Phenytoin sodium 300mg daily
• Clonazepam 1--2 mg thrice daily
(alternatively )
• Localized neuralgia may be treated by
injection of phenol or alcohol into the
branch of the nerve
6
7. Bell’ s palsy or facial
palsy
• Definition
• An idiopathic paresis or paralysis of
the facial nerve of sudden onset
• Clinical features
• There is no sex or age predilection
• Onset is usually as pain in the region
of stylomastoid foramen
7
8. Cont.
• Development of unilateral facial
paralysis
• Inability to close eye on the affected
side
• Mouth is drawn to the opposite side
• Dribbling of the saliva & fluids from
the angle of mouth
8
9. Cont.
• Impairment of sensation
• Whistling is impossible
• Speech becomes slurred
• Treatment
• Administration of oral
corticosteroids (dexamethasone 2mg
three times a day for five days)
9
10. Cont.
• Physiotherapy - it consists of
electrical stimuli by galvanism,
gentle massage & facial exercises
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