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Trigeminal neuralgy is a needlelike and stabbing pain in the area issue by the trigeminal nerve and it appears in turn rather than a continuous pain sometimes described as shoot pain . It is accompanied by facial cramp and tic in the face . It sometimes radiates to other parts of the scalp and also is companion by headaches , confuse vision , eye ache , etc .
What Leads To Trigeminal Neuralgia?
Trigeminal neuralgia is commonly idiopathic in nature which mean usually without cause . It commonly involves maxillary and mandibular branches of the trigeminal nerve . But accord to many researchers , it is most ordinarily consociate with vascular compression , aneurysmsand vascular torsion with the number as high as 36%[1 ] . It is also associate with autoimmune disease likesystemic lupus erythematosus , scleroderma , sarcoidosis , etc . It is also colligate with degenerative diseases likemultiple sclerosisetc . Sometimes various compressive lesions in the brain like tumors , metastasis , tuberculoma , cavernous hemangioma , etc . can also get the pain of trigeminal neuralgia by contract the nervus and its fence in structures .
Can Trigeminal Neuralgia Be Cured?
Most of the cases present to the clinic after the age of 50 years and can be treated on an outpatient groundwork . Although it may present as an irreversible disease it has a fairly secure prognosis . First pipeline management include medical treatment only . Most of the cases are either relieved by short term medication and are honorable enough to know the residuum of life without any further pain and the number ranges near 70%[1 ] . In only very few case , it can be treated by decompressing surgeries and neurological interventions . The cases which are associated with the degenerative disease are normally not relieve because of the uninterrupted advance of the disease .
Drugs used in relieving the neuropathic pain are unremarkably belong to anticonvulsant drug like Gabapentin , pregabalin , carbamazepine , oxcarbazepine , valproate , lamotrigine , Dilantin , topiramate , etc . Another group of drugs including tricyclic antidepressant drug like Elavil , nortriptyline can be used in the handling . Sometimes wasted musculus relaxant like baclofen , botulinum toxin are also used for relieving the symptom . Treatment of trigeminal neuralgia usually live for 6 - 12 month and the disease can go into remission itself . It may postulate starting the treatment again in the time to come but usually , it is not required . Sometimes more than one drug can be required because it may become dangerous enough to be not relieved by single medication .
Trigeminal neuralgia also has surgical discourse in medically resistant cases . Most common surgical discourse include vascular decompressing surgeries which are most effective because of its association with vascular malformations up to 36 % . Gamma tongue surgery is one of the efficacious surgeries for the handling . These are efficient for about 15 - 20 geezerhood and the patient is forthwith symptom - devoid and persist the same agency . stop of Gasserian ganglion of the trigeminal nerve by inebriant etc . is also done in various cases . Alcohol occlusion of peripheral nerves and stem of the trigeminal nerve are the intervention of the part and are not used nowadays due to the vast amount of side effects and very less selectivity .
Various percutaneous nerve blockage procedures are used nowadays due to the advance of the aesculapian field . Percutaneous retrogasserian glycerol rhizotomy [ PRGR ] , percutaneous balloon micro - condensation [ PBM ] and percutaneous radiofrequency trigeminal gangliolysis [ PRTG ] are few to name in transcutaneous procedures . These usually last for 2 - 5 year and sometimes infliction does not go back .
Conclusion
Trigeminal neuralgia is mostly due to idiopathic cause and no coition is found with other diseases . It is a curable disease with a very skillful success charge per unit and prognosis . aesculapian discourse has a very gamy achiever rate with generally a exclusive medicine in force for the treatment . operative intervention can become necessary in few of the intractable cases with high recurrence . Microvascular decompression is a unexampled field of surgeries opened in the intervention of trigeminal neuralgia and is currently the most efficient operative intervention as well . Although it is easy to diagnose even slightest facial features are to be acknowledge early to get near discourse and bar of the complications .
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