Trigeminal Palsey Flashcards
What is it
Dysfunction of the trigeminal nerve (cranial nerve V), which provides sensation to the face and controls the muscles of mastication.
Clinical Features
Facial numbness (partial or complete) 😶
Loss of corneal reflex (absent blink when the eye is touched) 👁️
Weakness in jaw movement (difficulty chewing) 🍽️
Jaw deviates to the affected side when opening
Pain or tingling (if trigeminal neuralgia is present) ⚡
Epidemiology
Rare condition -
neuralgia (related but distinct) is more common in older adults
CN V palsy often results from stroke, trauma, or tumors
Age Groups Affected
Young adults & middle-aged: More likely due to trauma or multiple sclerosis
Older adults (>50 years): More likely due to stroke or tumor compression
Risk Factors
✅ Modifiable:
Head trauma 🏍️🚗
Stroke risk factors (hypertension, diabetes, smoking) 🚬
Infections (e.g., herpes zoster, syphilis, Lyme disease) 🦠
Tumors (acoustic neuroma, meningioma)
🚫 Non-Modifiable:
Congenital syndromes affecting CN V
Demyelinating diseases (e.g., multiple sclerosis)
Clinical Presentation
🔹 Sensory Trigeminal Palsy (More Common)
Numbness/tingling or loss of facial sensation
Absent corneal reflex (risk of eye injury)
🔹 Motor Trigeminal Palsy (Less Common)
Jaw weakness, deviates to affected side
Difficulty chewing & speech issues
🔹 Trigeminal Neuralgia (If Associated)
Severe, sudden facial pain (shock-like, episodic) ⚡
Triggered by touching face, chewing, or talking
Prognosis
🔹 Depends on cause:
Stroke-related: Partial recovery possible with rehab
Trauma-related: Variable recovery, may need surgery
Tumor-related: Depends on successful treatment
🔹 Trigeminal neuralgia is chronic but can be managed with medications (e.g., carbamazepine)
Test
Soft and sharp test (V1, V2, V3)
Mastication test (V3)
Jaw reflex - can mention in OSPE
Corneal reflex - can mention in OSPE
