Trigeminal Neuralgia Flashcards

1
Q

risk factors for trigeminal neuralgia?

-3

A

Older age
Female
MS

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2
Q

which autoimmune disease increases risk of tri neuralgia by 20x?

A

MS

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3
Q

which trigeminal pathway does tears?

A

V1

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4
Q

autonomic symptoms of trigeminal neuralgia?

A

Lacrimation
Facial swelling
Rhinorrhoea
Ptosis

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5
Q

main symptom of trigeminal neuralgia?

A

severe unilateral pain

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6
Q

how long does pain last for?

A

Seconds to minutes

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7
Q

what sensation might pt feel across face?

A

Electric shock like sensation

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8
Q

main sign on examination?

-1

A

Pain on touch - allodynia

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9
Q

what category of diagnosis is this?

A

Clinical

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10
Q

pathophysiology of trigeminal neuralgia?

A

Trigeminal nerve is being compressed –> causing aberrant conduction along the trigeminal nerve –> produces neuropathic pain

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11
Q

what triggers the pain?

give e.g.?
-3

A

light touch

shaving, talking, washing.

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12
Q

in trigeminal neuralgia the trigeminal nerve is being compressed.

what is causing this compression?

A

vessel compressing it

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13
Q

which blood vessel commonly compresses on the trigeminal nerve?

what else can cause a vessel to pathologically compresses on the trigeminal nerve?
-2

A

superior cerebellar artery

aneurysms or AV malformation

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14
Q

is it theorised that compression on trigeminal nerve change the nerve’s structure, in what way?

A

removes myelin

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15
Q

Red Flag Symptoms for trigeminal neuralgia?

-7

A
Onset <40 years 
Pain only in ophthalmic division 
Optic neuritis 
Deafness 
Sensory changes 
Skin or oral lesions 
FHx of MS
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16
Q

1st line drug for trigeminal neuralgia?

  • name
  • group
A

Carbamazepine

anticonvulsant

17
Q

1st line drug for trigeminal neuralgia that is also used in epilepsy?

A

Carbamazepine

18
Q

1st line drug for trigeminal neuralgia?
-name

if this drug does not work what is 2nd line Mx?
-2 types

A

Carbamazepine

Surgery -microvascular decompression or ablative surgery

19
Q

Carbamazepine moa?

Carbamazepine two main uses?

A

Na+ channel blocker

seizures and neuropathic pain

20
Q

describe how microvascular decompression is done?

A

nerve and vessel separated, sponge placed between them

21
Q

Thermorhizotomy is used to ablate the trigeminal nerve.

what is Thermorhizotomy?

A

incinerate nerve

22
Q

Cryotherapy is used to ablate the trigeminal nerve.

what is cryotherapy?

A

freeze nerve

23
Q

Glycerol injection is used to ablate the trigeminal nerve.

how does this work?

A

deposit glycerol which is a corrosive chemical, so it destroys the nerve.

24
Q

Balloon compression is used to ablate the trigeminal nerve.

what is balloon compression?

A

inflated balloon compresses & damages nerve.

25
Stereotactic radiosurgery is used to ablate the trigeminal nerve. what is stereotactic radiosurgery
use radiation to the destroy nerve
26
which virus if it infects face can cause trigeminal neuralgia?
herpes zoster