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In the name of Allah, the Beneficent, the
Merciful.
TRIGEMINAL NEURALGIA
Also known as…
TIC DOULOUREUX
PROSOPALGIA
SUICIDE DISEASE
NEURALGIA EPILEPTIFORME
By: Aleshba Saba
Ro...
(INTRODUCTION)
TRIGEMINAL NEURALGIA
Sudden, usually unilateral
Brief, stabbing , electric shock like
recurrent pain
Pain is limited to the sensory distribution of
trigeminal nerve that includes middle face (maxillary
division V2)– being m...
• Vascular abnormality(venous or arterial) that
causes compression of trigeminal root,
adjacent to pons in posterior crani...
Normal
Neurovascular
compression
Tumor affecting CN V
Incidence
Usually develops after the age of 50, although
there have been cases with patients being as
young as three years...
Triggering factors
• Shaving, washing
• Stroking your face (trigger zones on face)
• Eating
• Drinking
• Brushing your tee...
SYMPTOMS
•Pain in areas supplied by CN V
•Usually unilateral
•Sharp, stabbing, electric
shock like pain
•Lasts for few sec...
TYPES OF
TRIGEMINAL NEURALGIA
PRE-TN
POST-
TRAUMIC
TN
2ndary
TN FAILED
TN
MULTIPLE
SCLEROSIS
RELATED
TN
ATYPICAL
TN
TYPICAL
TN
7
TYPES
Pre-trigeminal neuralgia
• Odd sensations of pain, (such as a toothache)
or discomfort (like “pins and needles”), may
be s...
Diagnosis &
Management
• History
• Examination (Odontogenic structures, cranial nerve
functions, related structures-muscles,TMJ,sinuses)
• Invest...
1st step of treatment- Pharmacotherapy
(Medical management of TN)
Trigeminal neuralgia is usually treated with drugs
calle...
2nd step of treatment- Surgery
Surgical options include:
1. Peripheral
• Cryotherapy
• Neurectomy
• Alcohol injections
2. ...
Non drug therapies
• Trancutaneus electric nerve stimulation
• Laser
• Rhizotomy
• Alcohol injections
There are some things that a patient can do to minimize
the frequency and intensity of TN attacks:
1. Apply ice packs. Col...
THANK YOU !
Reference
www.google.com (free search)
Lecture notes by Dr. Razzaq
Tyldesley’s oral medicine
Cawson’s Essentials of Oral M...
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trigeminal neuralgia.pptx - Slide 1

  1. 1. In the name of Allah, the Beneficent, the Merciful.
  2. 2. TRIGEMINAL NEURALGIA Also known as… TIC DOULOUREUX PROSOPALGIA SUICIDE DISEASE NEURALGIA EPILEPTIFORME By: Aleshba Saba Roll # 02 3rd Year BDS A neuropathic disorder of trigeminal nerve
  3. 3. (INTRODUCTION) TRIGEMINAL NEURALGIA Sudden, usually unilateral Brief, stabbing , electric shock like recurrent pain
  4. 4. Pain is limited to the sensory distribution of trigeminal nerve that includes middle face (maxillary division V2)– being most frequently involved, lower (mandibular division V3) & upper (ophthalmic division V1)– being least frequently involved
  5. 5. • Vascular abnormality(venous or arterial) that causes compression of trigeminal root, adjacent to pons in posterior cranial fossa • Association with MS • Tumors in post. Cranial fossa (2%) • Focal nerve injury • As a result of aging, shingles, unknown causes mostly Etiology
  6. 6. Normal Neurovascular compression
  7. 7. Tumor affecting CN V
  8. 8. Incidence Usually develops after the age of 50, although there have been cases with patients being as young as three years of age 150 per 1million (estimated) people suffer from TN Women are more likely to be affected than men (female:male – 2:1) Usually unilateral (3% cases show bilateral involvement)
  9. 9. Triggering factors • Shaving, washing • Stroking your face (trigger zones on face) • Eating • Drinking • Brushing your teeth • Talking • Putting on makeup • Encountering a breeze • Smiling
  10. 10. SYMPTOMS •Pain in areas supplied by CN V •Usually unilateral •Sharp, stabbing, electric shock like pain •Lasts for few seconds to minutes •This transient attack may be repeated in matter of minutes or hours
  11. 11. TYPES OF TRIGEMINAL NEURALGIA
  12. 12. PRE-TN POST- TRAUMIC TN 2ndary TN FAILED TN MULTIPLE SCLEROSIS RELATED TN ATYPICAL TN TYPICAL TN 7 TYPES
  13. 13. Pre-trigeminal neuralgia • Odd sensations of pain, (such as a toothache) or discomfort (like “pins and needles”), may be symptoms of pre-trigeminal neuralgia • Occur in 20% of patients who develop TN • Pre-TN is most effectively treated with medical therapy used for typical TN
  14. 14. Diagnosis & Management
  15. 15. • History • Examination (Odontogenic structures, cranial nerve functions, related structures-muscles,TMJ,sinuses) • Investigations Diagnostic local anesthetic nerve block (defines distribution of the pain, eliminate or confirm referred pain) Nerve conduction tests Imaging techniques (eliminate pain due to any other reason-odontogenic, sinus, postherpetic neuralgia, cluster headache, TMJ DS, atypical facial pain)
  16. 16. 1st step of treatment- Pharmacotherapy (Medical management of TN) Trigeminal neuralgia is usually treated with drugs called anti- convulsants which include: • Carbamazepine (drug of choice) (400-1000mg/day) • Phenytoin (300mg/day) • Oxycarbazepine • Gabapentin (600-1200mg/day) • Baclofen, lamotrigine, clonazepam
  17. 17. 2nd step of treatment- Surgery Surgical options include: 1. Peripheral • Cryotherapy • Neurectomy • Alcohol injections 2. Gasserian ganglion • Radiofrequency, thermocoagulation • Glycerol injection • Microcompression (balloon compression) 3. Posterior fossa • Neurovascular decompression • Stereotactic radiosurgery
  18. 18. Non drug therapies • Trancutaneus electric nerve stimulation • Laser • Rhizotomy • Alcohol injections
  19. 19. There are some things that a patient can do to minimize the frequency and intensity of TN attacks: 1. Apply ice packs. Cold often numbs the area and will reduce the pain 2.Get adequate rest in normal rest cycles 3.Manage your stress well and keep stress levels low 4. Avoid foods that may act as nerve stimulants, such as coffee, tea, and foods that are high in sugar 5. Maintain adequate hydration and electrolyte levels 6. Practice healthy living principles such as diet and exercise
  20. 20. THANK YOU !
  21. 21. Reference www.google.com (free search) Lecture notes by Dr. Razzaq Tyldesley’s oral medicine Cawson’s Essentials of Oral Medicine P-J Lamey- A clinical guide To Oral Medicine If you suffer, thank God! it is a sure sign that you are alive. -Elbert Hubbard

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