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24 Cards in this Set
- Front
- Back
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What is Trigeminal Neuralgia?
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- Vascular compression upon trigeminal nerve root
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What are the signs and symptoms of Trigeminal Neuralgia?
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- Sudden attacks of P. typically brief, lasting only seconds to 2 min
- Intense, stabbing or electrical shock-like - P. occurs on only 1 side- upper, middle and/or lower portion of face - Spontaneous or triggered by specific light stimulation (touch, talking, eating, drinking, tooth brushing, hair combing, water from shower and kissing) - Remain still and refrain from speech/movement |
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What is the progression of Trigeminal Neuralgia?
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More periods of remission and less periods of exacerbation in early disease course. Periods of exacerbation increases until it takes over in later disease course
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What is the diagnosis of Trigeminal Neuralgia?
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- Based on description of sufferer's P. and associated features
- Nurological and cranio-facial examinations and special tests usually normal |
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What is the incidence rate for trigeminal neuralgia??
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- Present in 100-200/100,000 ppl
- New cases: 5/100,000 /yr - Onset in later ages (25/100,000 ppl 70+ y/o) - Women more frequent - 2% develop other side of face |
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What are the 3 divisions of the Trigeminal N.?
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- Forehead and eye (opthalmic V1)
- cheek (maxilary V2) - lower face and jaw (mandibular V3) |
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Where do the 3 divisions of the trigeminal N. come together?
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Gasserion ganglion
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What is the difference btwn Typical and Atypical Trigeminal Neuralgia?
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- Typical: (most common) cause by blood vessels compressing trigeminal N. root, minor ache/burn P.
- Atypical: unilat, prominent constant and severe aching, boring or burning P. |
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What is Pre-trigeminal neuralgia?
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Before 1st attack of pain pt feels odd sensation: toothache, discomfort like pins & needles, parasthesia
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What is the review of symptom picture for trigeminal neuralgia?
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- Sudden unilat attacks, facial tics/spasm, loss of hearing possible, paralysis of mm of mastication --> jaw lock, loss of sensation in face
- Trigger zone: stimulation to lips, face or tongue - light touch, changes in temp, chew, shave, talk |
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What is the Tx for trigeminal neuralgia?
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- Medication
- Relaxation strategy - Acupuncture - Surgery for relief (decompression) |
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MT Tx for trigeminal neuralgia?
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- Contraindicated for trigger zones
- Focus on head, neck and shoulders - Full body relaxation massage btwn attacks |
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What is postherpetic neuralgia?
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- Complication of shingles (caused by chickenpox) > few weeks
- Affects nerve fibers and skin - Burning P. can interfere w/ sleep and appetite - Risk increases w/ age - No cure but Tx |
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What is the pain like for prostherpetic neuralgia?
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- Intense, deep, aching and unbearable
- Can interfere w/ sleep and appetite - Depression and social isolation can occur |
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What is the diagnostic test for prostherpetic neuralgia?
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- No specific test
- Go see Dr. for pts recovered from shingles and experience ongoing P. in region affected by initial shingles rash |
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What are the Tx options for postherpetic neuralgia?
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- Provide P. relief: skin patches, narcotic analgesics, antidepressants
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What is Intercostal Neuralgia?
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- Rare condition that causes P. along intercostal nerves (btwn ribs)
- Intercostal nerves can become damaged or inflamed - Often associated w/ injury or inflammation of N., mm, cartilage and lig in rib cage - Common cause: pregnancy, tumors, chest or rib injury, and surgery to chest or organs in chest cavity |
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What is the pain like for intercostal neuralgia?
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- Sporadic episodes of acute P. or P. that is dull and constant
- Stabbing, tearing, sharp, spasm-like, tender, ache or gnawing - Feels like P. wraps around upper chest in band-like pattern - Hinders: exertion or sudden movements involving upper chest EX. cough/laugh - severe P. --> difficulty breathing and moving effectively |
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What are the Tx options for intercostal neuralgia?
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- Avoid trigger zone
- Full body relaxation massage - Diaphragmatic breathing - Decrease hypertonicity of diaphragm - Rib springing |
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What is Glossopharyngeal Neuralgia?
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- Brief but intense P. on one side of throat which may radiate w/in mouth or into ear
- Similar to trigeminal neuralgia but involves glossopharyngeal and vagus CN and has similar progression as trigeminal neuralgia |
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What is the pain like for glossopharyngeal neuralgia?
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- Sharp, stabbing, burning
- May occur spontaneously or be provoke by talking, chewing, swallowing, coughing and yawning |
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What are the 3 forms of glossopharyngeal neuralgia?
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- Typical: caused by vascular compression of IXth and Xth CN roots entering lat medulla
- Atypical: involves prominent assocated ache/burn P. on involved side of face - Secondary: caused by tumor injuring glossopharyngeal N. in neck or base of skull |
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What is the surgical Tx for glossopharyngeal neuralgia?
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- Microvascular decompression surgery: relieves compression of blood vessels upon IXth and Xth CN roots emerging from lat medulla
- Doesn't injure nerves and cures GPN in about 3/4 pts |
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What is the MT Tx for GPN?
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