Trigeminal Neuralgia

Trigeminal Nerve 

The trigeminal nerve, or cranial nerve V, contains both sensory and motor components and therefore subserves and controls ipsilateral facial sensation and masticatory movements. Pain, thermal, tactile, and kinesthetic sensory stimuli are received in the facial skin, oropharynx, nasal mucous membranes, sinuses, teeth, palate, dura, and masticatory muscles. Motor fibers extend towards the muscles of mastication along with the tensor tympani and tensor veli palatini. The trigeminal brain stem nuclei would be the spinal trigeminal nucleus and tract, the primary (or principal) sensory nucleus, the mesencephalic nucleus, and also the motor trigeminal nucleus. The nerve splits into three divisions: V1 (the ophthalmic branch), V2 (the maxillary branch), and V3 (the mandibular branch). The neurons of those branches have their cell bodies within the gasserian (or semilunar) ganglion (with the exception of jaw proprioceptive fibers). The gasserian ganglion resides in Meckel's collapse the temporal bone.

Trigeminal Neuralgia History

The very first adequate clinical description from the condition trigeminal neuralgia was made by Fothergill in 1773. Thereafter, Charles Bell (1829) indicated that the trigeminal nerve subserved sensation towards the face. The trigeminal ganglion was excised within the late 19th century by Rose (1890), and also the celebrated surgeon Horsley first sectioned cranial nerve V with an intradural middle fossa approach in 1891. Early 20th-century studies focused totally on physiology, and more modern studies have integrated neurochemistry, neuropharmacology, and microsurgical interventions within the treatment of trigeminal lesions. In 1962, Blom first reported the successful management of trigeminal neuralgia with carbamazepine, a new antiepileptic agent in those days.

Trigeminal neuralgia pain- Chewing, speaking, cleansing the face, tooth brushing, cold winds or touching a particular 'trigger spot', e.g. upper lip or gum, could also precipitate an attack of pain. Trigeminal neuralgia additionally affects females and patients 50 plus years of age.

Trigeminal Neuralgia Investigations

Within the evaluation of suspected TN, an MRI from the brain is indicated, even when there is no loss of sensation or any other abnormality on neurological examination. Patient's good reputation for facial pain is essential. The value of a dental evaluation is uncertain.

There aren't any known associated disorders aside from the known or suspected reasons for secondary TN. Psychological problems may occur secondary to chronic pain. Secondary reasons for idiopathic TN other than Ms include syringomyelia, postmedullary infarction, aneurysm, basilar impression, and tumors, including acoustic neuromas, epidermoids, meningiomas, schwannomas, and cholesteatomas.