Trigeminal Neuralgia Flashcards
A condition of the 5th cranial nerve characterized by paroxysms of pain in the area innervated by any of the three brances
Trigeminal Neuralgia
Most commonly occurs in the second and third branches of the trigeminal nerve
Trigeminal Neuralgia
3 Branches of the Trigeminal Nerve
- Ophthalmic
- Maxillary
- Mandibular
Forehead, cheek, jaw area
Causes/Risks Factors
- Demyelination of axons in the ganglion, root, and nerve
- Multiple Sclerosis
- Swollen blood vessels or tumor
Trigeminal Neuralgia: Manifestations
- Pain that ends as abruptly as it starts and is described as a unilateral shooting and stabbing sensation
- Associated involuntary contraction of the facial muscles can cause sudden closing of the eye or a twitch of the mouth
Factors that can trigger
Washing the face, shaving, brushing teeth, eating, and drinking
Paroxysms can occur with any stimulation of the terminals of the affected nerve branches
Trigeminal Neuralgia: Surgical Management
- Microvascular Decompression of the Trigeminal Nerve
- Percutaneous Radiofrequency Thermal Coagulation
- Percutaneous Balloon Micro Compression
Intracranial approach used to decompress the trigeminal nerve by relieving the contact between the cerebral vessel and trigeminal nerve root entry
Microvascular Decompression of the Trigeminal Nerve
Relieves facial pain while preserving normal sensation, but is a major procedure, involving craniotomy
Microvascular Decompression of the Trigeminal Nerve
Produces a thermal lesion on the trigeminal nerve
Dysesthesia and loss of corneal reflex may occur
Percutaneous Radiofrequency Thermal Coagulation
Thermally destroying small unmyelinated and thinly myelinated fibers that conducts pain
Percutaneous Radiofrequency Thermal Coagulation
Disrupts large myelinated fibers of all 3 branches of the trigeminal nerve
Percutaneous Balloon Micro Compression
Balloon is filled with a contrast material for fluoroscopic identification and compresses the nerve root for 1 minute
Percutaneous Balloon Micro Compression
