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Neuropathic pain is a common phenomenon that affects millions of people worldwide. Maxillofacial structures consist of various tissues that receive frequent stimulation during food digestion. The unique functions (masticatory process and facial expression) of the maxillofacial structure require the exquisite organization of both the peripheral and central nervous systems. Neuralgia is painful paroxysmal disorder of the head-neck region characterized by some commonly shared features such as the unilateral pain, transience and recurrence of attacks, and superficial and shock-like pain at a trigger point. These types of pain can be experienced after nerve injury or as a part of diseases that affect peripheral and central nerve function, or they can be psychological. Since the trigeminal and glossopharyngeal nerves innervate the oral structure, trigeminal and glossopharyngeal neuralgia are the most common syndromes following myofascial pain dysfunction syndrome. Nevertheless, misdiagnoses are common. The aim of this review is to discuss the currently available diagnostic procedures and treatment options for trigeminal neuralgia, glossopharyngeal neuralgia, and myofascial pain dysfunction syndrome.
Trigeminal neuralgia and trigeminal-autonomic cephalalgias: a continuum or simple co-existence?
Cephalalgia, 2009
Trigeminal neuralgia (TN) is a common unilateral disorder characterized by brief electric shock-like pains, abrupt in onset and termination, limited to the distribution of one or more divisions of the trigeminal nerve. Indeed, pain is commonly evoked by trivial stimuli, including washing, shaving, smoking, talking, or brushing the teeth and frequently occurs spontaneously (1). Cluster headache (CH), short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms, and paroxysmal hemicrania (PH) are classified as trigeminal-autonomic cephalalgias (TACs). These cephalalgias, according to International Classification of Headache Disorders, 2nd edn (ICHD-II) criteria, share the clinical features of headache accompanied by cranial parasympathetic autonomic features (1). These syndromes seem to be different and well-characterized. However, in recent years some cases have been described in which syndromes co-existed or switched from one type to another in the same patient. This event raised doubt that there could be some common mechanisms among them. We describe a patient who resurrects this problem. She first presented with TN, later developed SUNCT, and then manifested TN attacks, followed by CH, and finally SUNCT without TN attacks.
TRIGEMINAL NEURALGIA -A CASE REPORT WITH REVIEW OF LITERATURE
WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES, 2021
Trigeminal neuralgia (TN) is a debilitating disorder that presents with a sudden onset of severe, unilateral, paroxysmal, and lancinating pain in one or more of the distributions of the trigeminal nerve. Trigeminal neuralgia affects the trigeminal nerve, fifth most developed and extensive cranial nerve, with a broad distribution territory. Its name - “trigeminal” - is derived from the fact that each nerve, one on each side of the pons, has three major branches: the ophthalmic nerve (V1), the maxillary nerve (V2) and the mandibular nerve (V3). The ophthalmic and maxillary nerves are purely sensory. The mandibular nerve has both sensory and motor functions.[1] It is a mixed nerve conducting sensitive and motor somatic fibers to the face, and is ideally responsible for all its sensitive innervation (touch, pain, temperature and propioception) together with the motor innervation of the mastication apparatus. Though it has been known by various names in the literature such as tic douloureux, trifacial neuralgia, fothergill’s disease (named after john fothergill), the currently accepted terminology is trigeminal neuralgia.[2]
Trigeminal neuralgia: literature review
The trigeminal nerve, fifth equal of cranial nerves, a mixed nerve is considered by possessing motor and sensitive components. The sensitive portion takes to the Nervous System Central somesthesics information from the skin and mucous membrane of great area of the face, being responsible also for a neural disease, known as the Trigeminal Neuralgia. The aim of this study was to review the literature on the main characteristics of Trigeminal Neuralgia, the relevant aspects for the diagnosis and treatment options for this pathology. This neuralgia is characterized by hard pains and sudden, similar to electric discharges, with duration between a few seconds to two minutes, in the trigeminal nerve sensorial distribution. The pain is unchained by light touches in specific points in the skin of the face or for movements of the facial muscles, it can be caused by traumatic sequels or physiologic processes degenerative associate the vascular compression. Prevails in the senior population, frequently in the woman. In a unilateral way it attacks more the maxillary and mandibular divisions, rarely happens in a simultaneous way in the three branches of trigeminal nerve three branches.
Trigeminal Neuralgia: Report of a Case and Literature Review
Medicine Today, 2014
Trigeminal neuralgia is a sudden, severe, stabbing, recurrent and usually unilateral pain in the distribution of one or more branches of the fifth cranial nerve. A 55 years old man, diagnosed case of Trigeminal Neuralgia of the left side of the face was treated with oral carbamazepine with good response. But after that the disease became refractory to the drug. With the titration of dose of carbamazepine, raising up to 1200 mg daily in three equal divided doses added with amitryptylene, we could give relief of pain to patient. The patient is now under observation & we are following him for last 6 months with a good response of the combination drug. It justifies that alteration, titration of carbamazepine and combination with amitryptylene can cause remission of trigeminal neuralgia instead of doing surgical intervention.
Trigeminal neuralgia: diagnosis and treatment
2005
Introduction: Trigeminal neuralgia (TN) is characterized by touch-evoked unilateral brief shock-like paroxysmal pain in one or more divisions of the trigeminal nerve. In addition to the paroxysmal pain, some patients also have continuous pain. TN is divided into classical TN (CTN) and secondary TN (STN). Etiology and pathophysiology: Demyelination of primary sensory trigeminal afferents in the root entry zone is the predominant pathophysiological mechanism. Most likely, demyelination paves the way for generation of ectopic impulses and ephaptic crosstalk. In a significant proportion of the patients, the demyelination is caused by a neurovascular conflict with morphological changes such as compression of the trigeminal root. However, there are also other unknown etiological factors, as only half of the CTN patients have morphological changes. STN is caused by multiple sclerosis or a space-occupying lesion affecting the trigeminal nerve. Differential diagnosis and treatment: Important differential diagnoses include trigeminal autonomic cephalalgias, posttraumatic or postherpetic pain and other facial pains. First line treatment is prophylactic medication with sodium channel blockers, and second line treatment is neurosurgical intervention. Future perspectives: Future studies should focus on genetics, unexplored etiological factors, sensory function, the neurosurgical outcome and complications, combination and neuromodulation treatment as well as development of new drugs with better tolerability.
A literature review on trigeminal neuralgia
Southeast Asian Journal of Health Professional
Out of all the cranial nerves “Trigeminal Nerve” is the fifth cranial nerve. Trigeminal nerve possesses both the components i.e. mixed components as well as sensitive components that’s why trigeminal nerve is known as a mixed nerve. The sensitive component of the trigeminal nerve takes up the sensation from most of the part of the face and the mucous membrane to the central nervous system and that’s why it is responsible for the disease which is known as trigeminal neuralgia. The characteristic feature of the trigeminal neuralgia is the sudden onset of pain which is sharp and lacerating, and that may last from few of the seconds to few minutes. Trigeminal neuralgia more frequently affects the female as compared to the male.