Trigeminal neuralgia - painful metry
* Introduction
* Symptoms and Diagnosis
* Treatment
Trigeminal sensory innervating facial skin surface and part of the scalp to the vertex. Trigeminal motor branch innervating the jaw muscles, masseter and pterigoid.
Trigeminal ganglia of peripheral sensory ganglia Gasser is situated on a cliff face anterosuperioara temporal bone. The path or peripheral trigeminal nerve receives sympathetic and parasympathetic numerous anastomotic branches from the spinal (cervical nice) or intermediate nerve of Wrisberg vegetative nucleus, which is joined and is distributed on the face. Thus, trigeminal phenomena involved in vasomotor, secretory and trophic face.
Trigeminal sensory consisting of Gasser ganglion cell dendrites, is divided into three branches: ophthalmic nerve, maxillary nerve and mandibular nerve.
- Ophthalmic nerve is a sensory nerve and is distributed to the vertex front skin, upper eyelids, the back of the nose, eye, cornea, conjunctiva, mucous frontal sinus, sphenoidal and ethmoid, part of the nasal mucosa, and in some portions of the dura mater, the cavernous sinus and anterior portion of the superior longitudinal sinus.
- Maxillary nerve is also a sensitive nerve. This region gentian innervating wing nose, upper lip, part of the nasal mucosa, maxillary sinus, palate, tonsils, gums and jaw jaw teeth.
- Mandibular nerve fibers contain both the sensitive and motor fibers to jaw muscles. Sensitive territory includes the temporal region of the mandibular nerve, superior maseterina region, chin, jugala mucosa, upper lip mucosa. Also innervates the floor of the mouth, gums mandible, mandibular teeth and two-thirds of the tongue earlier.
Facial neuralgia generally occurs around age 50, having a higher frequency in women. It distinguishes two types of facial neuralgia: neuralgia, primary and secondary neuralgia.
Causes
In neuralgia of the primary causes are not known. It criminalizes a lesion of unknown nature on one branch of the trigeminal nucleus or hyper sensitive. Some authors talamica home and thinks the pain.
Facial neuralgia secondary cases occur in general and local causes. In some cases this process can nerve neuritis.
The causes that can cause facial neuralgia are syphilis, influenza, malaria, diabetes, mercury or lead poisoning.
Sometimes neuralgia can occur after a tooth extraction.
Herpes virus is usually cantoneaza Gasser ganglion causing damage at this level, leading to painful crises, known as "gasserian syndrome. In the case of herpes zoster, neuralgic pain before rash appears and are maintained well after the disappearance of vesicles.
Among local causes, some are interested in peripheral nerve territory distribution: granuloma, dental cysts, tooth decay, jaw or mandibular osteitis, sinusitis, conjunctival lesions, glaucoma.
The trigeminal sensory root, and trunk and its branches can be damaged by: facial bone fractures, neoplasms infiltrating the skull base, meningitis, Gome. Middle cranial fossa tumors or trigeminal nerve (schwanoame) can produce a combination of sensory and motor signs. Cavernous sinus lesions can cause lesions in the first and second branch of the trigeminal and superior orbital fissure lesions may affect the ophthalmic branch.
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