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trigeminal_neuralgia

Trigeminal neuralgia

Trigeminal neuralgia (TN), a neuropathic pain syndrome, is defined by the International Association for the Study of Pain as “a sudden and usually unilateral severe brief stabbing recurrent pain in the distribution of one or more branches of the trigeminal nerve 1).

Also known as prosopalgia, or Fothergill's disease.

The clinical association between TN and hemifacial spasm is the so-called tic douloureux.

It has been described as among the most painful conditions known to mankind.

Trigeminal neuralgia and deafferentation neuropathic pain, or trigeminal neuropathy, are different symptomatologies, rarely reported to present together.

Epidemiology

Classification

Pathogenesis

Clinical Features

Classic trigeminal neuralgia (TN) involves sharp, shooting pain in any trigeminal nerve distribution, whereas atypical TN presents with constant aching, numbness or burning that can appear with classic features, leading to a mixed presentation or mixed trigeminal neuralgia.

The Visual Analog Scale (VAS) and the Barrow Neurological Institute Pain Scale (BNI-PS) are 2 of the most frequently employed patient-reported outcome (PRO) tools used by clinicians to rate pain for patients with trigeminal neuralgia (TN).

Diagnosis

Reinard et al., from the Department of Neurosurgery, Henry Ford Medical Group (HFMG), and the Wayne State University School of Medicine, Detroit, Michigan, identify racial and socioeconomic disparities in the diagnosis and treatment of trigeminal neuralgia (TN), this appeared to stem from outside HFMG from a difference in referral patterns to the neurologists and neurosurgeons 2).


Trigeminal Neuralgia can be a typical symptom in cerebellopontine angle tumours like epidermoid, especially in young patients, so all the patients with trigeminal neuralgia should be investigated for lesion in cerebellopontine region 3).

Magnetic resonance imaging (MRI) can be helpful in visualizing neurovascular conflict (NVC) of the trigeminal nerve, but the relationship between these two events is controversial.

Treatment

Outcome

Case series

1)
Garg RK, Malhotra HS, Verma R. Trigeminal neuralgia. J Indian Med Assoc. 2011;109:631–636.
2)
Reinard K, Nerenz DR, Basheer A, Tahir R, Jelsema T, Schultz L, Malik G, Air EL, Schwalb JM. Racial disparities in the diagnosis and management of trigeminal neuralgia. J Neurosurg. 2017 Feb;126(2):368-374. doi: 10.3171/2015.11.JNS151177. PubMed PMID: 26967783.
3)
Khan Afridi EA, Khan SA, Qureshi WU, Bhatti SN, Muhammad G, Mahmood S, Rehman A. Frequency of cerebellopontine angle tumours in patients with trigeminal neuralgia. . J Ayub Med Coll Abbottabad. 2014 Jul-Sep;26(3):331-3. PubMed PMID: 25671940.
trigeminal_neuralgia.txt · Last modified: 2018/12/10 14:39 by administrador