Trigeminal neuralgia
Trigeminal neuralgia is characterised by recurrent brief episodes of one-sided electric shock-like pains, sudden onset and termination, in the distribution of one or more divisions of the trigeminal nerve that are typically triggered by light touch on face. Trigeminal neuralgia is a rare condition that affects women more than men. Trigeminal neuralgia is commonly seen more in the older adult population. The incidence increases gradually with age; most idiopathic cases begin after the age 50, although onset may occur in the second or third decades or, rarely, in children.
The trigeminal nerve is the 5th cranial nerve. It is the sensory supply to the face and the sensory and motor supply to the muscles of mastication (chewing). It has three major divisions:
- Ophthalmic (V1)
- Maxillary (V2)
- Mandibular (V3)
The nerve starts at the midlateral surface of the pons, and its sensory ganglion resides in Meckel's cave in the floor of the middle cranial fossa.
Most common cause of trigeminal neuralgia is caused by compression of the trigeminal nerve root, usually within a few millimeters of entry into the pons. Compression by an artery or vein is thought to account for 80 to 90 percent of cases. Other causes of trigeminal nerve compression can be caused by vestibular schwannoma (acoustic neuroma), meningioma, epidermoid or other cyst, rarely, a saccular aneursym or arteriovenous malformation. The compression of the nerve leads to demyelination of the nerve causing the pain.
Hearing test
Hearing test is best done by audiologist as they have the equipment to do so. Hearing test is not covered under Medicare. However, there are people who will be eligible for free hearing test provided by Australian government through Hearing Service Voucher.
To be eligible to a Hearing Service Voucher, you must be an Australian citizen or permanent resident 21 years or older and you meet one of the following,
- Centrelink Pensioner Concession Card
- Centrelink Sickness Allowance
- DVA Pensioner Concession Card
- White Health Repatriation Card (for hearing loss)
- Gold Health Repatriation Card
- Are a member of the Australian Defence Forces
- Partner or dependent child of an eligible person
Here, I would like to give you some understanding of types of hearing loss. There are conductive hearing loss, sensorineural hearing loss or mixed (combination of both conductive hearing loss and sensorineural hearing loss).
Conductive hearing loss occurs when there is a problem conducting sound waves anywhere along the route through the ear canal, eardrum or the middle ear.
Sensorineural hearing loss is the problem with the hearing organs such as cochlear, vestibulocochlear nerve or auditory centre of the brain.
Tinnitus
Tinnitus is the perception of sound experienced by a person as noise in the absence of external noise. Tinnitus is not a disease itself. The sound can be buzzing, hissing, whistling, roaring, ringing, humming or hissing. It can be continuous or occur intermittently. It may be pulsatile or non-pulsatile. Tinnitus does not have to dramatically affect your quality of life. You should avoid focussing too much attention on your tinnitus. Avoid excessive noise, find relaxation and stress management techniques that work for you.
Approximately, 17 to 20% of Australians suffer from some degree of tinnitus, varying from mild to severe. It is common for a person's to be affected by stress or tiredness.
Tinnitus can be triggerred along the auditory pathway. The majority of patients have tinnitus due to hearing loss at the cochlea or cochlear nerve level. PET scanning and functional MRI studies indicate that the loss of cochlear input to neurons in the central auditory pathways (such as occurs with cochlear hair cell damage due to ototoxicity, noise trauma or a lesion of the cochlear nerve) can result in abnormal neural activity in the auditory cortex causing tinnitus.
Eustachian tube dysfunction
Eustachian tubes are small passageways that connect behind the nose to the middle ears. When you sneeze, swallow or yawn, the Eustachian tubes open to allow air to flow in and out. However, sometimes, Eustachian tubes can become blocked which is called Eustachian tube dysfunction. When this happens, sounds become muffled and your ear may feel full.
The most common causes of Eustachian tube dysfunction is caused by cold (flu) or sinusitis.
Most of the time, the Eustachian tube dysfunction will resolved without any treatment.