Sensory Disturbances Of Face and Jaws -Trigeminal Neuralgia

🔸Trigeminal Neuralgia

Q1. Define trigeminal neuralgia.

Ans. It is defined as sudden, usually unilateral severe, brief, stabbing, lancinating, recurring pain in the distribution of one or more branches of the fifth cranial nerve. It is also called as tic douloureax, Father gill disease.

Q2. Mention the various aetiology of trigeminal neuralgia.

Ans. Various aetiology of trigeminal neuralgia are mentioned below:

1. Vascular factors.
2. Mechanical factors.
3. Anatomy of superior cerebellar artery.
4. Infections.
5. Ratners jaw bone cavity.
6. Multiple sclerosis.
7. Post traumatic neuralgia.
8. Intracranial tumors.
9. Intra oral vascular abnormalities.
10. Viral etiology.

Q3. Explain briefly the management of trigeminal neuralgia?

Ans. For the management of trigeminal neuralgia :

1. Medical.
2. Surgical.

Q4. Classify medical management of trigeminal neuralgia?

Ans. Classification of medical management of trigeminal neuralgia :

1. Carbamazepine.
2. Intramuscular morphine.
3. Trichloroethylene.
4. Diphenylhydantoin sodium.

Q5. Mention in detail about extracranially treatment of neuralgia.

Ans. Extracranially treatment of neuralgia:

1. Alcohol block in peripheral nerve.
2. Nerve section and avulsion.
3. Electrosurgery.
4. Cryosurgery.
5. Radio frequency thermocoagulation.

Q6. Enumerate various neurectomy procedures.

Ans. There are various neurectomy procedures namely :

1. Supra orbital.
2. Infra orbital.
3. Lingual.
4. Inferior alveolar Gin Walla’s technique]
5. Braun’s trans oral approach.

Q7. Classify various intracranial surgical procedures for neurectomy?

Ans. Classification of various intracranial surgical procedures for neurectomy :

1. Alcohol blockade C gasserian gangilon.
2. Radio frequency thermocoagulation of gasserian ganglion.
3. Hetrogasserian rhizotomy.
4. Medullary tractotomy.
5. Mid brain tractotomy.
6. Intra cranial nerve decompression

– Jannetta’s approach

– Dandy’s approach.

Q8. Describe newer approaches in the treatment of trigeminal neuralgia.

Ans. Newer approaches in the treatment of trigeminal neuralgia :

1. Acupuncture.
2. Physiologic inhibition of pain by transcutaneous neural stimulation.

Q9. Classify psychological approaches in the treatment of trigeminal neuralgia?

Ans. Classification of psychological approaches in the treatment of trigeminal neuralgia :

1. Biofeedback.
2. Psychiatric counselling.
3. Hypnosis/auto suggestion.

🔷SENSORY DISTURBANCES OF FACE AND JAWS :

Q1. Define Allodynia.

Ans. It is defined as pain due to a stimulus that does not normally provoke pain.

Q2. Define Analgesia.

Ans. It is defined as absence of pain in response to stimulation that would normally be painful.

Q3. Define Dysesthesia.

Ans. An unpleasant painful abnormal sensation either spontaneous or evoked patient complains of numbness associated with burning.

Q4. Define Hyperesthesia.

Ans. It is defined as increased sensitivity to stimulus.

Q5. Define Hypoesthesia.

Ans. It is defined as decreased sensitivity to stimulation.

Q6. Define Hypo and hypergesia.

Ans. It is defined as decreased or increased response to a stimulus that is normally painful.

Q7. Define Ageusia.

Ans. It is defined as loss of taste.

Q8. Define Neuritis.

Ans. It is defined as transmission of pain impulse passed along the course of the nerve.

Q9. Classify Nerve injury.

Ans. Seddon (1943) of sunderland (1978) have proposed nerve Injury. It is applied to both motor and sensory nerves.

Q10. Classify seddon’s classification.

Ans. Seddon’s classification

1. Neuropraxia.
2. Axonotmesis.
3. Neurotmesis.

Q11. Define Tinel’s sign.

Ans. It was used as an earlier indication of the start of nerve regeneration. It is elicited by percussion over the divided nerve, which result in a tingling sensations in the part supplied by the peripheral section.

Q12. Define Neuropraxia.

Ans. It is defined as mild temporary injury caused by compression or retraction of the nerve. There is no axonal degeneration

distal to the area of injury. There is a temporary conduction block.

Q13. Define Axonotmesis.

Ans. There is more significant injury, with disruption or loss of continuity of some axons, which undergo wallerian degene-

ration distal to the site of injury.

Q14. Define Neurotmesis.

Ans. It is complete severance or internal physiologic disruption of all layers of the nerve. Wallerian degeneration of all axons

occurs distal to the injury. There is total permanent conduction block of all impulses.

Q15. Define Neuroma.

Ans..It is characterised by disorganised Micro Sprouting and formation of a disorganised mass of collagen and randomly oriented small neural fascicles.

Q16. Classify Neuromas.

Ans. Classification of Neuromas

• Amputation/Stump Neuromas.
• Central neuroma.
• Electric neuroma.

1. Lateral exophytic.
2. Stellate neuroma.

Q17. Enumerate various methods of treatment of nerve injuries.

Ans. There are various methods of treatment of nerve injuries :

1. Medical [Vitamin B12 supplements]
2. Surgery [Neurorrhaphy]