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The End
6. Treatment for TN
6.1 Medical Treatment： 6.1.1 Carbamazapine is the gold standard for initial
treatment.
6.3 Operation for TN:
6.3.1 Percutaneous procedures:
3.Etiology of TN
TN (Etiologic Point)
Idiopathic TN (MVC 80%, AT, et)
Symptomatic TN (MS 1.7-5%, Tumors 0.8-
11.6%)
4. Pathology of TN
4.1 TN is a kind of non-nociceptive pain, which is caused by compression or damage to nerves instead of stimulation to algesiroreceptor . 4.2 Peripheral and central theory of TN: MVC, demyelination, ectopic impulse in trigeminal nerve, sensory reflex epilepsy, etc.
2. Prevalence and Incidence
2.1 150,000 people are diagnosed with TN every year（annual occurrence is 35/100,000)
2.2 Over the age of 50 (52-69).
2.3 More common in women than in men （F/M，1.74/1).
5.4 Different Diagnosis of Facial Pain
General causes of orofacial pain
General principles in the medical management of facial pain. TCAs, tricyclic antidepressants.
In 3D-TOF, signal of venous is isointensive.
The image of nerve in FIESTA stage is superior to it in 3D-TOF stage.
6.3.2.3 Operative technique：
6.3.3 Radiotherapy:
三叉神经痛和微血管减压 ppt课件(9)
1. Definition of Trigeminal Neuralgia
Trigeminal neuralgia (TN, or TGN), also known as prosopalgia, suicide disease, or Fothergill's disease, is a neuropathic disorder characterized by episodes of intense pain in the face, originating from the trigeminal nerve.
Radiofrequency thermal; Glycerol injection; Microcompression;
6.3.2 Open Surgery (MVD):
6.3.2.1 Theoretical Basis: 6.3.2.2 Preoperative evaluation:
3D MRI: 3D time of flight (3D- TOF) , 3D constructive interference in steady – state( 3D -CISS) , fast imaging employing steady- state acquisition (FIESTA).
The maxillary branch (V2) sensation covers the lower eyelid, the side of the nose, the upper lip and cheek, and the upper teeth and gums.
The mandibular branch (V3) is responsible for sensation of the lower teeth and gums, lower lip, chin, jaw, and part of the ear. It is also responsible for supplying the muscles involved with chewing (mastication), those muscles involved with chewing.
5. Clinical characters of TN
5.1 Dermatome of TN
The ophthalmic branch (V1) is responsible for sensation from the scalp, forehead, upper eyelid and tip of the nose.
5.2 Major clinical features of TN
TN (Symptomatic Viewpoint)
Typical TN (Paroxysmal Pain)
Atypical TN (Paroxysmal and Constant Pain)
5.3 Diagnostic criteria of TN (From HIS):