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Questions and Answers
What is the most common age group affected by trigeminal neuralgia?
What is the characteristic of pain in trigeminal neuralgia?
What is the purpose of identifying a trigger zone in trigeminal neuralgia?
What is the female-to-male ratio of trigeminal neuralgia incidence?
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Which of the following distributions is most commonly associated with trigeminal neuralgia trigger zones?
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What is the characteristic response of trigeminal neuralgia to increasing stimulation?
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What is the primary characteristic of pain caused by trigeminal neuralgia (TN) that distinguishes it from other types of pain?
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What is the likely cause of the pain in trigeminal neuralgia (TN)?
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Why might a dentist mistakenly attribute the pain of trigeminal neuralgia (TN) to a dental problem?
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What is the role of anticonvulsants in the treatment of trigeminal neuralgia (TN)?
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What is the primary goal of the dentist when encountering a patient with suspected trigeminal neuralgia (TN)?
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What is the significance of the site of demyelination in trigeminal neuralgia (TN)?
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Study Notes
Trigeminal Neuralgia (TN)
- TN is a type of neuropathic facial pain that can be difficult to distinguish from dental pain, such as acute pulpitis or periapical periodontitis.
- The pain of TN has a burning or electric shock-like quality, and can be accompanied by a background aching pain.
- Local anesthetic block of the trigger zone can arrest the pain of TN, leading to mistaken diagnosis of a "dental" cause.
Cause of TN
- The exact cause of TN is not clear, but it is believed to be caused by pressure on the root entry zone of the trigeminal nerve by a vascular loop, leading to focal demyelination.
- This demyelination can cause ectopic or hyperactive discharge of the nerve.
Clinical Presentation
- The site of demyelination determines the trigeminal division involved and hence the clinical presentation.
- Other diseases, such as multiple sclerosis, tumors, and Lyme disease, can produce similar pain.
Treatment of TN
- Treatment of TN is medical or surgical, with medical treatment typically involving anticonvulsants such as carbamazepine, gabapentin, and oxcarbazepine.
- Surgical treatment includes microvascular decompression of the offending vascular loop, Gamma Knife radiosurgery, percutaneous needle thermal rhizotomy, or balloon compression of the root entry zone.
Importance of Accurate Diagnosis
- Accurate diagnosis of TN is critical to avoid unnecessary dental treatment or extractions.
- Unnecessary dental treatment is common when the trigger zone is located in an intraoral, dental, or periodontal site.
Characteristics of TN
- TN typically occurs in patients older than 50 years, with a female-to-male ratio of 1.6:1.
- The pain is intense, lasting for brief periods of seconds to 1 minute, followed by a refractory period.
- A background aching or burning pain is often present, and a trigger zone is commonly found, where mechanical stimuli can provoke an attack.
- Trigger zones can occur in the V2, V3, or V1 distributions, with V2 and V3 being the most common.
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Description
Learn about the symptoms, diagnosis, and characteristics of Trigeminal Neuralgia, a type of neuropathic facial pain that affects the trigeminal nerve. This quiz covers the details of this condition, including its incidence, demographics, and pain patterns.
