Thursday, October 27, 2011

A Note on Trigeminal Neuralgia with no Apparent Organic Cause

Trigeminal Neuralgia with no Apparent Organic Cause

Such conditions have many names: idiopathic trigeminal neuralgia, trigeminal neuralgia, benign paroxysmal trigeminal neuralgia, tic doloureux.
Trigeminal neuralgia is the most common neurological cause of orofacial pain. It is, however, rare and seen mainly in middle-aged or older patients.
Aetiology
The cause is unclear, but trigeminal neuralgia may be due to an atherosclerotic blood vessel pressing on the roots of the trigeminal nerve.
Clinical Features
Trigeminal neuralgia has the following main characteristics.
Pain which is:
  •  severe;
  •  of abrupt onset and termination;
  •  electric shock-like, brief, stabbing (lancinating);
  •  unilateral;
  •  restricted to the trigeminal nerve distribution.
The pain usually involves the mandibular and, rarely, the other divisions of the trigeminal nerve. In some patients the pain is triggered. The trigger site may bear no relation to the painful area, but is always ipsilateral to the pain. Patients do not necessarily recognize the trigger for what it is, and may find that pain is brought on by chewing, talking, swallowing, smiling or temperature changeóusually exposure to cold air.
Pain-free Intervals Between Attacks
This is often an intermittent disease, with apparent remissions for months or years. However, recurrence is common. Very often the pain spreads to involve a wider area over time and the intervals between episodes tend to shorten.
Lack of Neurological Abnormality
There is no sensory loss in the trigeminal region; nor are other neurological abnormalities present. Neurological assessment is needed because similar pain is secondary to multiple sclerosis, tumours, neurosyphilis, HIV infection and other lesions.
Diagnosis and Management
Patients with trigeminal neuralgia are ideally seen at an early stage by a specialist in order to confirm the diagnosis and initiate treatment

Roles of the dental clinical team in the management of a patient with trigeminal neuralgia
Dental surgeon
Ancillary, Hygienist, Nurse
Refer to specialist. Understand disease and
management in order to extend education of, and reassure, patient

Alert specialist to any possible adverse
effects of treatment

Oral healthcare; in particular to avoid
causes of pain

Oral health education of patient

Avoid any trigger zones

Avoid drug interactions with carbamazepine
or other agents
Understand disease and management in order to
extend education of, and reassure, patient

Oral health education of patient

Avoid any trigger zones

Alert dental surgeon to any changes, or possible
adverse effects of treatment

Patient information sheet: trigeminal neuralgia
This is an uncommon disorder

The cause is unknown but involves spontaneous activity of pain nerves

It is not inherited

It is not known to be infectious

Similar symptoms may be seen in some neurological conditions (which we will exclude)

There are usually no long-term consequences

X-rays and blood tests may be required

Symptoms may be controlled but not cured by drugs with an anticonvulsant action

Uncontrolled pain may be treated by freezing the nerve, or by surgery

Medical treatment, typically using anticonvulsants, is successful for most patients. Carbamazepine (Tegretol) is still the main agent used. It must be given continuously prophylactically for long periods. However, it is not an analgesic and, if given when an attack starts, will not relieve the pain.
Carbamazepine must be used carefully and under strict medical surveillance because it can have a range of adverse effects, particularly affecting balance, blood cells, blood pressure and liver function. Typically, the dose is increased to try to control the pain while at the same time trying to avoid ataxia and other adverse effects. If carbamazepine fails, phenytoin or baclofen or other drugs are occasionally useful.
If medical treatment fails or the adverse drug effects are too pronounced, surgery may be required. Injections of local analgesic will temporarily block the pain. Local cryosurgery to the trigeminal nerve branches involved (cryoanalgesia) can produce analgesia without permanent anaesthesia, but the benefit can usually be measured only in months rather than years.
For intractable cases neurosurgery, such as destruction of the trigeminal ganglion (radiofrequency ganglionolysis) or decompression of the trigeminal nerve, may be required. Unfortunately, pain is exchanged for anaesthesia and risk of damage to the cornea and, occasionally, continuous anaesthesia but with pain (anaesthesia dolorosa).


Trigeminal Neuralgia ppt 1

Trigeminal Neuralgia ppt 2

Trigeminal Neuralgia....A Video


Download PPT 1  and PPT 2

12 comments:

  1. Concise and to the point. 5 stars

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  3. Am Richard, I am here to testify about a great herbalist  man who cured my wife of breast cancer. His name is Dr Imoloa. My wife went through this pain for 3 years, i almost spent all i had, until i saw some testimonies online on how Dr. Imoloa cure them from their diseases, immediately i contacted him through. then he told me the necessary things to do before he will send  the herbal medicine. Wish he did through DHL courier service, And he instructed us on how to apply or drink the medicine for good two weeks. and to greatest surprise before the upper third week my wife was relief from all the pains, Believe me, that was how my wife was cured from breast cancer by this great man. He also have powerful herbal medicine to cure diseases like: Alzheimer's disease, parkinson's disease, vaginal cancer, epilepsy Anxiety Disorders, Autoimmune Disease, Back Pain, Back Sprain, Bipolar Disorder, Brain Tumor, Malignant, Bruxism, Bulimia, Cervical Disc Disease, Cardiovascular Disease, Neoplasms , chronic respiratory disease, mental and behavioral disorder, Cystic Fibrosis, Hypertension, Diabetes, Asthma, Autoimmune inflammatory media arthritis ed. chronic kidney disease, inflammatory joint disease, impotence, alcohol spectrum feta, dysthymic disorder, eczema, tuberculosis, chronic fatigue syndrome, constipation, inflammatory bowel disease, lupus disease, mouth ulcer, mouth cancer, body pain, fever, hepatitis ABC, syphilis, diarrhea, HIV / AIDS, Huntington's disease, back acne, chronic kidney failure, addison's disease, chronic pain, Crohn's pain, cystic fibrosis, fibromyalgia, inflammatory Bowel disease, fungal nail disease, Lyme disease, Celia disease, Lymphoma, Major depression, Malignant melanoma, Mania, Melorheostosis, Meniere's disease, Mucopolysaccharidosis, Multiple sclerosis, Muscular dystrophy, Rheumatoid arthritis. You can reach him Email Via drimolaherbalmademedicine@gmail.com / whatsapp +2347081986098    Website/ www.drimolaherbalmademedicine.wordpress.com

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  4. Read carefully, it's said that Huntington disease has no cure, yes with the western medication but not with herbal medicine, my daughter's situation made me to realize that with doctor Bharat herbal medicine it can be cured. In 2014 she experienced difficulty in concentrating, memory lapses and depression, at first I taught it was stressed from her place of work until I took her to hospital and the doctor made me to understand that it's juvenile Huntington disease because she is still in her late 20s, which she inherited from my late husband that died of the same disease, the doctor told me it has no cure, but gave her some medicine which I noticed that it has side effects, my daughter situation got worst each day that passes, she was the best at her place of work, now a shadow of her self because of this deadly disease, she speaks to herself often, she was really going insane, I do not want to lose my daughter the same way I lost her father, in 2018 I carried out research on internet and bumped into a comment of a lady that got cured of Huntington disease, without wasting time I contacted doctor Bharat whose name was mentioned in the comment, now is been 3 years my daughter is living her best life again, for those that have the disease or have any love one suffering from Huntington disease, contact doctor Bharat via dr.bharatkings@gmail.com

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  5. Does anyone still doubt natural herbs? I have seen the great importance of natural herbs and the wonderful work they have done in people's lives. I wonder why people still spend their money on English medicine when natural herbs can cure all kinds of mental diseases. I have seen it with my own eyes. My dad and aunt were cured from Huntington disease with Dr Bharet herbal medicine. He used BUJA herbal medicine to cure my dad and aunt from Huntington disease, I know it is hard to believe but am a living testimony. My dad was diagnosed with Huntington's disease in 2016, we have made use of all western medication yet no improvement and his doctors said there is no cure yet but still carrying out research, my dad experienced depression, anxiety and memory lapses that made him hallucinate always, he speaks to himself often and that made me shed tears each night that passes by. 2019 I searched through the internet for a solution and i came across a comment on a blog written by [Robert Jane] saying she was cured of Huntington disease that she suffered from for 8years. Without wasting time I quickly contacted Dr Bharat whose name was mentioned in the comment Via his email. He asked me questions which I answered correctly he sent his herbal medicine to us here in Ireland through DHL, in less than one month I started seeing positive improvement on my Dad's health so I introduced the medication to my aunt as well, is been 4 years now, my dad and aunt are living their best life again. Though i gave the medication as i was instructed. My dad and aunt are Huntington disease negative after the medication, Huntington disease is completely gone from my family lineage. With Bharat herbal medicine called BUJA Huntington patients can smile again. For those with Huntington disease or having their love ones diagnosed with Huntington's disease contact Dr Bharat now via dr.bharatkings@gmail.com you will come back to testify

    ReplyDelete
  6. I want to make this testimony public and as a sign of gratitude to Dr Bharat. On how he saved my husband from Huntington's disease with his herbal medicine called BUJA, i decided to reach out to those still suffering from this disease.
    My husband suffered Huntington disease and it was really tough and heartbreaking for me because he was all i have and the symptoms were terrible, my husband experience hallucination, depression, anxiety, abnormality walking, involuntary movement and memory impairment. We tried various therapies prescribed by our neurologist but none could cure him instead the situation got worsen each day that passes by. I spent much money yet no improvement, I really do not want my husband to die so i searched for a cure on the internet and i bumped into a testimony of (Ronda Jasil) who got cured from Huntington's disease. and she left the e-mail address of the Herbal doctor who has the cure of Huntington disease. I never imagined Huntington's disease has a cure until i contacted him and he assured me my husband will be fine. I got the herbal medication he recommended and my husband used it and in one month we started seeing improvement, now is been 1year and 6 months my husband is okay and full of life again. Huntington's disease has a cure and it is a herbal medicine called BUJA. contact doctor Bharat now on dr.bharatkings@gmail.com Thanks for reading my testimony

    ReplyDelete
  7. Hi everyone, this is good news, a perfect and greats one. My daughter of
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    was done says my daughter is Huntington's disease negative. She got cured with Dr Bharat herbal medicine, this is super amazing. My daughter is fully okay and back to her work again. I can boldly say that Huntington's disease is 100% curable with doctor Bharat herbal medicine, is real, anyone with Huntington's disease or have love ones that is suffering from Huntington's disease should contact doctor bharat now on his mail. dr.bharatkings@gmail.com

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  8. My sister had severe Muscle problems, abnormal eye movements, Difficulty with the physical production of speech, memory lapses. she was placed on tranquilizers 3 times daily, it helped her but not very much. Her neurologist advised us to try natural treatments and introduced me to Natural Organic Herbs, {Huntington disease Herbal formula}, I visited his blogs and read a lot of positive reviews from other patients who used the treatment and made my orders. We immediately started on the treatment for my sister. she had great improvement and relief with this treatment, total decline of symptoms. All her symptoms left and she has been reserved from Huntington Disease. Great improvement with speech, co-ordination, balance, muscle, mood etc, I gained back my life with this herbal treatment and can never be thankful enough. Visit Natural Organic Herbs, reach him directly via {dr.bharatkings@gmail.com}. She's now living like a normal person without any symptoms of Huntington Disease. All thanks to Dr. Bharat

    ReplyDelete
  9. My name is Esther from Los Angeles USA, I want to shed my testimony because I know it will help some people out there. My husband Charles was diagnosed with Huntington's disease in 2017, I watch my husband living like a mad person sometimes i shed tears. After several failed attempts to make him well again, I searched on the internet for a cure but there was none, in 2019 I bump into a comment on YouTube on how Dr. Bharat cured a woman who also suffered from Huntington's for 6 years with his herbal medicine. Without wasting time I contacted him and he asked me a few questions which I answered then he prepared the medication and sent them to me here in LA with a prescription on how to use attached to it. I administered it to my husband as prescribed, within 2 months i start seeing improvements in his health and he was totally healed in 6 months, now my husband is living his best life again. You can contact Dr. Bharat via dr.bharatkings@gmail.com you will come back to testify

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