Trigeminal Neuralgia
Basics
Description
Description
- The trigeminal nerve innervates the face, oral mucosa, nasal mucosa, and cornea with its sensory fibers
- Trigeminal nerve = Cranial nerve (CN) V
- Synonym: Tic douloureux:
- Tic = spasmodic muscular contraction
- Douloureux = painful
- Usually occurs in patients >50 yr of age
- Most common age group is 50–60 yr
- Females > males
- Facial pain syndrome recognizable by history alone
- Classical:
- Paroxysmal attacks of unilateral (rarely bilateral) pain affecting 1 or more divisions of the trigeminal nerve
- Has 1 of the following characteristics:
- Superficial
- Sharp
- Stabbing pain
- Precipitated from trigger areas or factors
- Lasts for <1 s–2 min
- Episodes are stereotyped in each individual
- No clinically evident neurologic deficit
- Not caused by another disorder
- Symptomatic:
- Same as above but a causative lesion (not vascular compression) is identified
Etiology
Etiology
- Mechanism of pain production remains controversial; accepted theory suggests:
- Demyelination of CN, leading to ectopic stimulation and pain:
- Demyelination caused by tortuous or aberrant vascular compression of nerve root
- 80–90% of classical trigeminal neuralgia have compression
- Superior cerebellar artery is the most common (75%)
- Anterior inferior cerebellar artery (10%)
- Demyelination of CN, leading to ectopic stimulation and pain:
- Secondary causes:
- Herpes zoster
- Multiple sclerosis
- Space-occupying lesions:
- Cerebellopontine angle tumor
- Aneurysm
- Arteriovenous malformation
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Citation
Schaider, Jeffrey J., et al., editors. "Trigeminal Neuralgia." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307153/all/Trigeminal_Neuralgia.
Trigeminal Neuralgia. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307153/all/Trigeminal_Neuralgia. Accessed November 21, 2024.
Trigeminal Neuralgia. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307153/all/Trigeminal_Neuralgia
Trigeminal Neuralgia [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 November 21]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307153/all/Trigeminal_Neuralgia.
* Article titles in AMA citation format should be in sentence-case
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T1 - Trigeminal Neuralgia
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ED - Barkin,Adam Z,
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ED - Rosen,Peter,
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ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307153/all/Trigeminal_Neuralgia
PB - Lippincott Williams & Wilkins
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DB - Emergency Central
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