SPECTRUM OF TRIGEMINAL NEURALGIA

Abdur Rehman, Iram Abbas, Shahbaz Ali Khan, Ehtisham Ahmed, Fozia Fatima, Syed Abbas Anwar

Abstract


Background: Trigeminal neuralgia (TN) is a very painful condition characterized by paroxysmal shock like pain in the distribution of one or more branches of trigeminal nerve caused by neuro-vascular conflict at the root entry zone of trigeminal nerve. This study was conducted to analyse the demography and pattern of TN in our setup. Methods: This descriptive study was conducted in the Oral Surgery unit, Department of Dentistry, Ayub Medical College, Abbottabad, from April 2009 to October 2011. A total of 117 patients were included in study by convenience (non probability) sampling technique. All the patients presenting with the clinical features of TN were included in study. Results: Out of 117 cases, 49 (41.9%) were males and remaining 68 (58.1%) were females. Age of the patients ranged from 32–72 (53.90±10.21) years. Right side was involved in 63 patients (53.8%), while the left side was involved in 51 patients (43.6%). In only three cases (2%) there was bilateral involvement. The maxillary division was involved in 68 cases (58.1%) and mandibular division was involved in 37 cases (31.6%). The most common site of involvement was infra-orbital, which was involved in 68 cases (58.11%). The next common site was the mental nerve which showed involvement in 35 cases (29.9%) followed by inferior alveolar nerve which was affected in 14 cases (12%). Thirty three (28.2%) patients were having mild pain, 54 (46.2%) patients having moderate, 21 (18%) patients with severe and 9 (7.7%) patients were having very severe pain. No patient in our study had a family history of TN. Among our patients 103 (88%) patients underwent dental extraction for the same pain. Conclusion: The incidence of TN is more in old age especially in females. TN is frequently misdiagnosed in with tooth ache, so there is need to educate the medical practitioners and masses in order to avoid un-necessary tooth extractions.

Keywords: Trigeminal neuralgia, Neuralgia, Trigeminal nerve

Full Text:

PDF

References


Civelek E, Cansever T, Imer M, Hepgul K, Barlas O. Trigeminal neuralgia and treatment options. Agri 2005;17:19–26.

Malik NA. Trigeminal Neuralgia and its management. In: Malik NA (Ed). Textbook of Oral & Maxillofacial Surgery. (2nd ed.) New Dehli: Jaypee Brothers; 2008.p. 685–97.

Apfelbaum RI. Comparison of long term results of microvascular decompression and percutaneous trigeminal neurolysis for the treatment of trigeminal neuralgia. International Congress series 2002;1247:629–43.

Cheshire WP. Trigeminal neuralgia: for one nerve a multitude of treatments. Expert Rev Neurother 2007;11:1565–79.

Petit JH, Herman JM, Nagda S, Dibiase SJ, Chin LS. Radiosurgical treatment of trigeminal neuralgia: evaluating quality of life and treatment outcomes. Int J Radiat Oncol Biol Phys 2003;56:1147–53.

Shaya M, Jawahar A, Caldito G, Sin A, Willis BK, Nanda A. Gamma knife radiosurgery for trigeminal neuralgia: a study of predictors of success, efficacy and safety, and outcome at LSUHSC. Surg Neurol 2004;61:529–34.

Love S, Coakham HB. Trigeminal neuralgia, Pathology and Pathogenesis. Brain 2001;124:2347–60.

Chen JF, Lee ST. Comparison of percutaneous trigeminal ganglion compression and microvascular decompression for the management of trigeminal neuralgia. Clin Neurol Neurosurg 2003;105:203–8.

Toda K. Etiology of trigeminal neuralgia. Oral Sci International 2007;4:10–8.

Toda K. Trigeminal neuralgia-symptoms, diagnosis, classification, and related disorders. Oral Sci International 2007;4:1–9.

Toda K. Operative treatment of trigeminal neuralgia: review of current techniques. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:788–805.

Casey KF. Role of patient history and physical examination in the diagnosis of trigeminal neuralgia. Neurosurg Focus 2005;18(5):E1

Hai J, Li S, Pan Q. Treatment of atypical trigeminal neuralgia with micro-vascular decompression. Neurol India 2006;54:53–6.

Rana ZA, Malik AM, Rana IZ. Aggravating and relieving factors in Trigeminal neuralgia; PIMS experience. Ann Pak Inst Med Sci 2005;1:32–6.

Ali M, Khan KM, Khanzada KA, Ayub S, Khan H. Significance of the trigger point in the trigeminal neuralgia. J Post Med Inst 2007;21:183–6.

Khetab U, Khan M, Ud Din R, Wahid A. Trigeminal neuralgia: A study of 242 patients. Pak Oral Dent J 2005;25:163–6.

Khan I, Nadeem M. Percutanous reterogassarian glycerol rhizotomy in the management of trigeminal neuralgia. Rawal Med J 2008;33:225–7.

Olson S, Atkinson L, Weidmann M. Microvascular decompression for trigeminal neuralgia: Recurrences and complications. J Clin Neurosci 2005;12:787–9.

Ahmed M, Majid A, Butt R, Ahmed N. Preoperative finding of microvascular decompression for trigeminal neuralgia: a study of 102 patients. Surgimed Med Dent J 2009;1:9–13.

Katusic S, Beard M, Bergstrahl E, Durland LT. Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota,1945–1984. Ann Neurol 1990;27:89–95.

Gomez-Arguelles JM, Dorado R, Sepulveda JM, Herrera A, Arrojo F, Aragon E, et al. Oxcarbazepine monotherapy in carbamazipine –unresponsive trigeminal neuralgia. J Clin Neurosci 2008;15:516–9.

Sohail A, Saeed M, Qazi SR. Efficacy of peripheral glycerol injection in the management of trigeminal neuralgia. Pak Oral & Dent J 2006;26:93–6


Refbacks

  • There are currently no refbacks.


Contact Number: +92-992-382571

email: [jamc] [@] [ayubmed.edu.pk]