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Sunday, December 27, 2015

Trigeminal Neuralgia

Trigeminal Neuralgia

Also known as tic douloureux, trigeminal neuralgia is an idiopathic pain syndrome resulting in sudden, severe, sharp pain starting near the side of the mouth and progressing to the ear, eye, or nostril. Attacks can be triggered by touch or movement such as talking or by eating. Trigeminal neuralgia can be so severe as to be nearly incapacitating. The pain lasts for a few seconds and disappears. Despite the pain, the sensory examination will be normal. Generally, trigeminal neuralgia is felt to be secondary to compression of the trigeminal nerve root by a blood vessel. Occasionally it can be a manifestation of multiple sclerosis or a posterior fossa tumor. With the exception of multiple sclerosis or the posterior fossa tumor, all imaging and neurologic testing will be normal.
Carbamazepine is the standard of care for treatment. In those not controlled with carbam- azepine, phenytoin, baclofen, or gabapentin can be tried. In those not responding to any form of medical therapy, surgery or radio-frequency lesioning into the affected nerve may work.

1 comment:

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