Accommodation to Diagnosis of Trigeminal Neuralgia

Abstract

SUMMARY -Trigeminal neuralgia is one of the most common causes of facial pain. It implies short lasting episodes of unilateral electric shock-like pain with abrupt onset and termination, in the distribution of one or more divisions of the trigeminal nerve that are triggered by innocuous stimuli. Most cases of trigeminal neuralgia are caused by compression of the trigeminal nerve root. Depending on the etiology, trigeminal neuralgia can be classifi ed as classic trigeminal neuralgia or painful trigeminal neuropathy. It may be precipitated by some actions at trigger zones. Th e diagnosis of trigeminal neuralgia is based on diagnostic criteria for classic trigeminal neuralgia, neuroimaging and electrophysiologic trigeminal refl ex testing. Treatment of classic trigeminal neuralgia for most patients is pharmacological therapy, while surgical approach is reserved for patients that are refractory to medical therapy and in cases of painful trigeminal neuropathy.

Predictability of Fused 3D-T2-SPACE and 3D-TOF-MRA Images in Identifying Conflict in Trigeminal Neuralgia

“…Trigeminal neuralgia (TN) is caused by compression of the trigeminal nerve root by an aberrant loop of an artery or vein in 80% to 90% of the cases. 1 The most basic and effective treatment, in this case, is microvascular decompression (MVD), which can relieve symptoms in most cases completely. Patients with typical symptoms of TN, positive magnetic resonance findings, or the evident presence of neurovascular compression or conflict (NVC) are likely to benefit from MVD.…”

Orofacial pain – diagnostic and therapeutic challenges

“…The application of etiopathogenetic models of the origin of TMDs on certain patients with clinical signs and symptoms is not completely possible and therefore, the application of personalized/person-centered medicine concepts in chronic pain management is necessary ( 9 , 22 , 23 ). Orofacial pain (musculoskeletal, neuropathic, neurovascular) has a prevalence of up to 22-26% in general population, out of which 7-11% have chronic pain ( 2 , 8 , 24 ). The prevalence of pain in the TMJ and masticatory muscles is relatively low (around 2-7%).…”

“…It is difficult to determine the prevalence because the disease is often not recognized as neuralgia; hence symptomatology is in dental practice initially related to odontogenic pain of unclear etiology. The complete and conclusive diagnostics as well as treatment procedures are the responsibility of a neurologist ( 8 ). Also, his responsibility is co-morbidity of trigeminal neuralgia or pain related to trigeminal neuralgia and many systemic diseases which may induce orofacial pains (TMDs) or whether trigeminal neuralgia is an accompanying condition to the main disease (metabolic and endocrine diseases, rheumatic diseases, etc.)…”

“…Neuropathic pain is pain initiated or caused by a lesion of the peripheral or/and central nervous system manifesting with sensory symptoms and signs. Trigeminal neuralgia is characterized by unilateral disorder characterized by short-term attacks of pain such as an electrical shock which suddenly emerges and stops, and is limited to the innervation area of one or more trigeminal nerve branches ( 8 ). Persistent pain is the second neuropathic entity occurring in the orofacial region.…”

MRI-derived neurovascular compression score provides the indication of surgical treatment of patients with primary trigeminal neuralgia: A validated multi-center study

“…Trigeminal neuralgia (TN) is an exemplary condition of neuropathic facial pain, characterized as shortlasting episodes of unilateral electric shock-like pain with abrupt onset and termination (1,2). Patients usually had characteristic paroxysmal pain and concomitant continuous pain in 50% of patients (2).…”