MICRO
CNS (1).pptx

Epidemiology tn is a rare condition that affects

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Epidemiology:- TN is a rare condition that affects women more than men. The incidence increases gradually with age; most idiopathic cases begin after age 50. 243
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Etiology and pathogenesis:- Most cases of TN are caused by compression of the trigeminal nerve root, usually within a few millimeters of entry into the pons (the root entry zone ). Compression by an aberrant loop of an artery or vein is thought to account for 80 to 90 percent of cases. 244
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Classification:- In the International Classification of Headache Disorders, 3rd edition (ICHD-3), TN is divided into classic (or classical) trigeminal neuralgia caused by neurovascular compression and painful trigeminal neuropathy caused by a number of other conditions. 245
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Clinical features:- TN defined clinically by paroxysmal, stereotyped attacks of usually intense, sharp, superficial, or stabbing pain in the distribution of one or more branches of the fifth cranial (trigeminal) nerve. The pain of TN tends to occur in paroxysms and is maximal at or near onset. Facial muscle spasms can be seen with severe pain. 246
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This finding gave rise to the older term for this disorder, “tic douloureux”. The pain is often described as electric, shock-like or stabbing. It usually lasts from one to several seconds , but may occur repetitively. 247
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TN is typically unilateral. Occasionally the pain is bilateral , though rarely on both sides simultaneously. The distribution of pain most often involves the V2 and/or V3 subdivisions of the trigeminal nerve. 248
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Lightly touching these zones often triggers an attack, leading patients to protect these areas. Other triggers of TN paroxysms include chewing, talking, brushing teeth, cold air, smiling, and/or grimacing. Unlike some other facial pain syndromes, TN typically does not awaken patients at night. 249
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Autonomic symptoms, usually mild or moderate, can occur in association with attacks of TN in the V 1 trigeminal distribution, including lacrimation, conjunctival injection, and rhinorrhea. The most common division of the trigeminal nerve involved in trigeminal neuralgia is the maxillary division (V2) followed by the mandibular division (V3). 250
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Diagnosis:- The diagnosis of TN is based upon the characteristic clinical features described above , primarily paroxysms of pain in the distribution of the trigeminal nerve. Once the diagnosis of TN is suspected on clinical grounds, a search for secondary causes should be undertaken . Trigeminal neuralgia was also known as Suicide disease. 251
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All of the following statements about Trigeminal Neuralgia are true except - (NBE/DNB Pattern) a) Most commonly involves ophthalmic division of Trigeminal nerve b) Attacks most commonly occur during the day c) Affects women more than men d) More common on the Right side A 252
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Drug of choice for Trigeminal Neuralgia is - (NBE/DNB Pattern) a) Chlorpromazine b) Carbamezapine c) Gabapentin d) Fluoxetine 253
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254
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Drug of choice for Trigeminal Neuralgia is - (NBE/DNB Pattern) a) Chlorpromazine b) Carbamezapine c) Gabapentin d) Fluoxetine B 255
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  • Winter '16
  • jean grey

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