PRIMARY TRIGEMINAL NEURALGIA

Zheng Dongming

Neurology Ward

I.DEFINITION

Primary trigeminal neuralgia refers to paroxysmal brief severe pain within the distribution of trigeminal nerve,usually without organic disease of the nerve.

II.ETIOLOGY AND PATHOLOGY

• Etiology: unknown

• Pathology: no definite conclusion

III.CLINICAL FEATURE1.sex and age

• Sex:female:male=2:1~3:2

• Age: 70%~80% patients >40 years old

III.CLINICAL FEATURE2.distribution

• any of the 3 divisions (2,3)

• unilateral • marked in

cheek,jaw,tong-ue

III.CLINICAL FEATURE3.characteristics of the pain

• brief:seconds~2mins

• severe:tic douloureux.

• “ Trigger area ”

• paroxysmal

III.CLINICAL FEATURE(4)sign

No positive sign

IV.DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS

Diagnosis:based on clinical feature

Differential diagnosis:toothache

sinusitis

nasopharyngeal cancer

secondary TN

V.TREATMENT

• General treatment:analgesic and sedative drugs

• Medicine:carbamazepine,phenytoin,clonozepam

• Injection of phenol or alcohol

• Surgery