Trigeminal Neuralgia Flashcards
What causes Trigeminal Neuralgia?
Pathoanatomy/physiology
CN 5 compressed at base of brain by blood vessels or tumors
Foramen Ovale and Foramen Rotundum are smaller on Right Side, causing compression
What are the four main pathways of the Trigeminal System?
1)
2)
3)
4)
What are 4 Signs or Symptoms of Trigeminal Neuralgia?
1) Knife-Like Pain along CN 5 and branches
2) Motor and Sensory systems IN TACT
3) Triggered by sensory stimulation (chewing, smiling, shaving, etc.)
4) Right Side > Left Side
What are 5 treatment options for Trigeminal Neuralgia?
1) Medications:
Carbamazepine (Anti-Convulsant)
Anti-epileptics and Anti-Anxiety meds
2) Topical skin analgesics or Botox
3) Percutaneous Procedures (Glycerol to Foramen Ovale)
4) Invasive Surgery (remove skull, decompress nerve)
5) Biofeedback / Neurofeedback
What differentiates Trigeminal Neuralgia from Trigeminal Neuropathy?
Neuralgia: Just Pain
Neuropathy: Sensory or Motor Deficits
What are 3 keys for DDx for Trigeminal Neuralgia?
1) Subjective History Signs/Sx’s
2) Cranial Nerve Testing (Especially Corneal Blink Reflex)
3) Rule out TMJ, Dental, or tumor
Biofeedback vs. Neurofeedback?
Biofeedback gives patients control over ______ and involves ________
Neurofeedback gives patients control over ______ and involves ________
Biofeedback gives patients control over
Physiological Responses
and involves
Neurofeedback gives patients control over
Neurological Responses
and involves
What are some important history questions for Trigeminal Neuralgia?
1)
2)
3)
What role do PT’s have with Trigeminal Neuralia?
1) TENS or Low-Level Laser
2) Massage
3) Low-Intensity Spinal Mobilizations?
4) Diaphragmatic Breathing
5) Desensitization Training
6) Pain modulation through exercise
Prognosis/Outcomes for Trigeminal Neuralgia?
Unpredictable due to spontaneous nature of disease.
PT cannot completely treat TN, but can give pain-management techniques
