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.
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