International Journal of Dental Sciences & Research - Volumes & Issues - Volume 4: July 2024, Issue 1

TRIGEMINAL NEURALGIA – DIAGNOSIS ANDTREATMENT: A REVIEW

Authors

Rajdeep Kaur, Alka, Sahil, Ketan Bali, Deepak Verma, Lovepreet Singh

DOI Number

Keywords

Trigeminal neuralgia, craniofacial, neurovascular compression, tic douloureux, Microvascular decompression

Abstract

The trigeminal nerve (V) is the fifth and largest of all cranial nerves and it is responsible for detecting sensory stimuli that
arise from the craniofacial area. The nerve is divided into three branches: ophthalmic (V1), maxillary (V2), and mandibular
(V3); their cell bodies are located in the trigeminal ganglia and they make connections with second-order neurons in the
trigeminal brainstem sensory nuclear complex. Trigeminal neuralgia (TN), also known as tic douloureux, is a chronic pain condition
characterized by recurrent brief episodes of electric shock-like pains affecting the fifth cranial (trigeminal) nerve, which
supplies the forehead, cheek, and lower jaw.Diagnosis is essentially clinically; magnetic resonance imaging is useful to rule
out secondary causes, detect pathological changes in affected root and neurovascular compression (NVC). Carbamazepine is
the drug of choice; oxcarbazepine, baclofen, lamotrigine, phenytoin, and topiramate are also useful. Multidrug regimens and
multidisciplinary approaches are useful in selected patients. Microvascular decompression is surgical treatment of choice in
TN resistant to medical management. Patients with significant medical comorbidities, without NVC and multiple sclerosis
are generally recommended to undergo gamma knife radiosurgery, percutaneous balloon compression, glycerol rhizotomy,
and radiofrequency thermocoagulationprocedures. Partial sensory root sectioning is indicated in negative vessel explorations
during surgery and large intraneural vein. Endoscopic technique can be used alone for vascular decompression or as
an adjuvant to microscope. It allows better visualization of vascular conflict and entire root from pons to ganglion including
ventral aspect. The effectiveness and completeness of decompression can be assessed and new vascular conflicts that may
be missed by microscope can be identified.

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Journal

International Journal of Dental Sciences & Research

ISSN

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Periodicity

Bi-Annual