Pathophysiology of Trigeminal Neuralgia

        Emphasis on the mechanics of blood vessels when the nerve root into the brain stem which is most often the case, while the portion above the trigeminal nerve / portio minor rare. Blood vessels in normal people do not intersect with the trigeminal nerve. This suppression can be caused by arterial or venous both large and small that may be just touching or bent on the trigeminal nerve.

Trigeminal Neuralgia

Patient with Trigeminal Neuralgia

       Trigeminal neuralgia is a disorder characterized by paroxysmal attacks of severe pain, and short in coverage of one or more nerves branch of the trigeminal nerve, usually without evidence of organic neurological disease. . This disease causes severe facial pain. This disease is also known as ticdoulourex or Fothergill's syndrome.

Medical Treatment and Therapy of HNP

Treatment

a. Conservative when no neurologic deficits encountered:

- Sleep for 1-2 hours on a hard mattress
- Exercise is used to relieve pressure or compression of nerve
- Drug therapy: muscle relaxants, nonsteroidal, anti-inflammatory and analgesic drug.
- Hot and cold therapy.
- Immobilization or brancing, using a lumbosacral brace or corset.
- Therapeutic diets to lose weight
- Lumbar Traction, may help, but usually Resides
- Transcutaneus Electrical Nerve Stimulation (TENS).

Clinical Symptoms and Diagnosis of HNP

Clinical Symptoms
a. Low back pain is intermittent (within a few weeks to several years). Pain spreading according to the distribution of the sciatic nerve.
b. The nature of pain changed from lying to sitting position, ranging from back pain and continued to spread to the back and then to the lower leg.
c. Pain intensified as the originator of such movements waist when coughing or straining, standing, or sitting for long periods of time and reduced pain at rest or lying down.
d. Patients often complain of tingling (paraesthesia) or numbness even decreased muscle strength in accordance with the distribution of the involved nerves.
e. Pain increases when the L5-S1 region (line between the two iliac crest) is pressed.
f. If left unchecked, it will slowly lead to lower limb weakness / leg
g. conus or cauda equina if affected, can occur defecation disorders, micturition and sexual function. This situation is a neurological emergency that requires surgery to prevent permanent damage function.
h. Habits of patients need to be observed, when sitting more comfortable then sitting on the healthy side.