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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 constant
Or paroxysmal remission.
CAUSES
1.Trigeminal nerve
compression
2.Headache
3.Toothache

4.Sinusitis
5.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
NEURALGIA
1.INTERMITTENT TWINGES OF MILD PAIN

2.SEVERE EPISODE OF SEARING,SHOOTING,JABBING PAIN THAT FEELS LIKE ELECTRIC SHO
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 APPROAC
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 TRIGEMINAL
NEURALGIA
GOALS OF SURGEON DURING SURGERY

1.DECOMPRESSION OR 2 SEVERING OF THE NER
SURGICAL
APPROACH

1.MICROVASCULAR DECOMPRESSION S
2.PERCUTANEOUS GLYCEROL RHIZOTOM
3.PERCUTANEOUS BALLON COMPRESSI
NERVE (PBCTN)
4.PERCUTANEOUS STEREOSTATIC RADI
THERMAL RHIZOTOMY (PSRTR)
5.PARTIAL SENSORY RHIZOTOMY
6.GAMMA KNIFE RADIOSURGERY
MVD
PREVENTION

There are no guildlines for preventin g the
development of trigeminal neuralgia,but
You can only take steps to prevent the attack.
TIPS TO AVIOD ATTACKS

1.EAT LUKEWARM FOODS AND DRINKS
2.EAT SOFT FOOD
3.AVIOD KNOWN TRIGGERS.
4.USE COTTON PADS WHEN WASHING YOUR FACE
WELCOME TO,OUTSIDE
THE BOX THOUGHT
PROCESS

1901
2 CONCLUSIONS

1904
Trigeminal Neuralgia ,
Trigeminal Neuralgia ,

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Trigeminal Neuralgia ,