Trigeminal nerve palsy

Trigeminal nerve palsy
Of the three branches of the trigeminal nerve, ophthalmic, maxillary and mandibular, only the last contains motor fibers.
Mandibular branch wreath is a mixed fiber containing both sensory and motor fibers.
Motor root originates in the nucleus of mastic and located in the lateral pontine cap.
Mandibular wreath, in terms of motor, innervating the temporal muscle, masseter, pterygoid, external and internal, milohioidian, anterior portion digastricului, peristafilinul external and middle ear muscle hammer.

 
Causes

There are many causes that can lead to paralysis of the motor branches of the trigeminal nerve.

 
In the brainstem trigeminal nerve palsy may be caused by a vascular process (usually a thrombotic disorder), and tumors of the brain stem encephalitis.

 
In the Gasser ganglion paralysis may be caused by tumor infiltrating the skull base or tumors of the ponto-cerebellar angle, Gome syphilitic, tuberculoame, meningitis of different etiologies, suppurations ethmoid cells and middle ear or not at least the basic fracture skull.

 
Paralysis can occur in case of poliradiculonevrite. Bilateral paralysis occurs during siringomielobulbiei and amyotrophic lateral sclerosis.

 
Clinical

In unilateral paralysis, the patient shows a decrease in the movements of mastication, the anterior side and the projection of the mandible. During the motion of opening / closing jaw mouth action going off sick by the external pterygoid muscle on the opposite side.

 
Temporal and masseter muscles on the affected side are atrophied. Fasciculations may be seen in masseter and temporal muscles.

 
Also as a result of trophic disorders is the occurrence of corneal ulceration with corneal opacity, a phenomenon called keratitis nerve. In the area of ophthalmic disease characteristic blisters appear in the cornea and skin innervated by the ophthalmic ram.

 
Corneal reflex is diminished or abolished the affected side. And maseterin reflex is abolished. Mandible to the chin percussion determine the contractile response of the masseter muscle of the only undamaged.

 
In bilateral lesions of the geniculate beam cerebral arteriosclerosis, bulbar syndrome, or amyotrophic lateral sclerosis, maseterin reflex is exaggerated bilaterally.

 
If bilateral trigeminal nerve is paralyzed, then fall mandubulei notice and attempt to lift them is diminished or abolished according to the intensity of the lesion. Also, the patient can not perform the act of mastication.

 
Treatment

It is medicinal and equal to that of trigeminal neuralgia.