Monday, October 20, 2008

Trigeminal Neuralgia Information

"Trigeminal neuralgia is an idiopathic disorder, but several theories of neuropathological processes attempt to explain the symptoms. One theory is compression of the trigeminal root adjacent to the pons, causing demyelination of the nerve root. This may be caused by tortuous blood vessels in the posterior fossa, tumors, or arteriovenous malformations. However, these structural lesions are not found in all patients with Trigeminal neuralgia. Other theories suggest that Trigeminal neuralgia is a symptom of a central nerve disease or a disease of the trigeminal vascular system involving dysfunctional interplay between a trigeminal sensory plexus and blood vessels located in the pia and dura mater.Trigeminal neuralgia is usually caused by an intracranial artery (eg, anterior inferior cerebellar artery, ectatic basilar artery) or, less often, a venous loop that compresses the 5th cranial (trigeminal) nerve at its root entry zone into the brain stem. Other less common causes include compression by a tumor and occasionally a multiple sclerosis plaque at the root entry zone, but these are distinguished usually by accompanying sensory and other deficits. Other disorders that cause similar symptoms (eg, multiple sclerosis) are sometimes considered to be trigeminal neuralgia and sometimes not. "
References-
Green MW, Selman JE. Review article: the medical management of trigeminal neuralgia. Headache. 1991;31:588-592.
Cheshire WP. Trigeminal neuralgia: a guide to drug choice. CNS Drugs. 1997;7: 98-110.
Turp JC, Gobetti JP. Trigeminal neuralgia versus atypical facial pain: a review of the literature and case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81:424-432.
Fromm GH, Terrence CF, Maroon JC. Trigeminal neuralgia: current concepts regarding etiology and pathogenesis. Arch Neurol. 1984;41:1204-1207
Rappaport ZH, Devor M. Trigeminal neuralgia: the role of self-sustaining discharge in the trigeminal ganglion. Pain. 1994;56:128-138.

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