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.

trigeminal nerve

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.

Conjunctivitis is a common infection of the eyes. Conjunctivitis means inflammation of the conjunctiva. The conjunctiva is the mucous membrane that lines the inside surface of the lids and covers the surface of the globe up to the limbus (the junction of the sclera and the cornea).

Causes:

  • Bacterial
  • Viral
  • Allergic

Bacterial conjunctivitis is more common in children. It is commonly caused by Staphylococcus aureus, Steptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Bacterial conjunctivitis is spread by direct contact with the patient and his or her secretions or with contaminated objects and surfaces. Patients typically complain of redness and discharge of the affected eye.

Viral conjunctivitis is usually caused by adenovirus. The conjunctivitis may be part of a early onset of viral infection followed by adenopathy, fever, pharyngitis, and upper respiratory tract infection, or the eye infection may be the only manifestation of the disease. It is high contagious and spread by direct contact with the patient and his or her secretions or with contaminated objects and surfaces. Patients typically complain of watery discharge, burning, sandy or gritty feeling in one eye. Viral conjunctivitis is a self-limited process. The symptoms frequently get worse for the first three to five days, with gradual resolution over one to three weeks.

Allergic conjunctivitis is caused by airborne allergens contacting the eye. It typically presents as both eye redness, watery discharge and itching.

Achalasia is motility disorder of esophagus. Achalasia is a rare disorder affecting about 1.6 per 100,000 individuals. Both men and women are equally affected. The disease usually occurs between the ages of 25 and 60 years. The primary cause of Achalasia is unknown. Secondary cause of Achalasia can be due to Chagas disease caused by protozoan parasite, Trypanosoma Cruzi which occurs predominantly in Central and South America.

Achalasia4