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Trigeminal Neuralgia

Trigeminal Neuralgia is a chronic pain condition resulting from a trigeminal nerve disorder that is the nerve to 5 which will give the sensation of pain from the face to your brain. The piercing pain can be felt in areas of cheek, lips, chin, nose, forehead, or gum on one side of the face. If you have trigeminal neuralgia, this pain can be triggered by some things like chewing or touching the face area. This pain can occur in seconds to a few minutes. The episodes of perceived pain may last several weeks to several years.

SYMPTOMS

Trigeminal neuralgia has such symptoms

  • Pain that is quite severe feels like a shot and a sense of piercing
  • A sudden onset of pain or a pain attack caused by a touch of a face, chewing, talking, or brushing.
  • This pain attack can last for a few seconds to several minutes
  • Pain lasting several seconds to several seconds
  • Continuous pain and burning sensation
  • Sometimes pain is felt on some faces, sometimes both
  • The pain focuses on a single point or spreads over a larger area

DIAGNOSIS

The diagnosis of trigeminal neuralgia is done through anamnesis and neurological examination of the trigeminal nerve. This examination is done by examining the localization of pain, when the onset of pain, pain free distance, duration of pain, response to treatment, and history of other diseases. Other examinations can be done through investigation through a CT Scan head or MRI Head. CT Scan head is done to be able to detect the presence of tumors and aneurysms.

 

CAUSE

Trigeminal neuralgia is caused by abnormalities of the veins and arteries that compress the nerves

How to Heal

  1. Operation Actions

The surgery is done to stop the pressure from the blood vessels that suppress the trigeminal nerve, or cut off the nerve to keep the pain signals from attacking the brain. This surgical procedure is performed by general anesthesia, then made a hole in the skull bone called a craniotomy, and this action takes time to hospitalize for 1-2 days. The actions that can be done are:

 

  • MVD ( Microvascular Decompression) </ i> </ em>

Microvascular Decompression (MVD) is an action to relieve abnormal pressure on cranial nerve compression. This action is done to treat trigeminal neuralgia (a neurological disease that causes severe facial pain), glossopharyngeal neuralgia, and spasm hemafisisal. This action can relieve pain but can also cause serious side effects. Action MVD needs to open the skull (craniotomy) to insert a sponge between the nerves and the offending artery of the vein that can cause pain. Because MVD involves the use of general anesthesia and brain surgery, patients with other medical conditions or who are in poor health can not be given an action. MVD can not treat facial pain due to multiple sclerosis.

MVD can not be performed in patients with hearing loss as this may result in the risk of hearing loss.

 

Operating Risk MVD

 

Most of the surgeries are at risk. Complications that may arise in general are bleeding, infection, swelling of blood vessels, and anesthetic reactions. Other specific complications associated with craniotomy include stroke, convulsions, venous sinus occlusion, brain swelling, and cerebrospinal fluid (CSF). The specific complications associated with MVD are nerve damage that varies and depends on the nerve being treated, including hearing loss, double vision, numbness, facial paralysis, hoarseness, difficulty swallowing, and unstable walking.

 

Sensory Rhizotomy

It is the act of cutting off the trigeminal neuralgia nerve root connected to the brain stem. This operation is performed by permanently cutting the ganglion gassery, but this surgical procedure can cause total numbing, therefore this operation procedure is performed only if any other surgical and therapeutic techniques are unsuccessful.

 

Procedures using Needles

This procedure is a technique to reach the trigeminal nerve neuralgia without making a skin incision or opening the skull bone. This action is done using a hollow needle that is disispkan through the cheek skin to the trigeminal neuralgia nerve. The purpose of this action is to be able to damage the trigeminal nerve area so as not to send pain signals to the brain, but this can cause numbness in the area.

 

Some healing actions using needles include:

  • </ i> Radifrequency rhizotomy </ em> or Stereotactic Radiofrequency Rhizotomy (PSR) , </ i> </ em> is an action by inserting a paired heat needle to destroy some trigeminal neuralgia nerve fibers that produce pain. Asleep this electrode needle is inserted into the cheek and reaches the trigeminal neuralgia nerve.
  • Injection using glycerol, this procedure is similar to the PSR procedure and incorporates glycerol fluid to destroy painful trigeminal neuralgia nerve fibers. However, because when entering the glycerol fluid can not be controlled it is likely to produce unpredictable results. </ i>
  • Balloon compression, a procedure similar to PSR since the hollow needle is also inserted through the cheek but this procedure requires general anesthesia. This procedure is done by placing a balloon in the trigeminal nerve using a catheter. Then the balloon will increase and press on the part that generates the pain, then the balloon and catheter in the lift back.

 

Peripheral Neuroktomi

This procedure requires a skin incision to reach the nerves in the face and then cut off the supraorbita nerve (if pain in the upper part of the forehead) or cut off the infraorbital nerve (if the pain is at the bottom of the eye at the very top of the cheekbone.

Radiosurgery

The radiosurgery procedure aims to kill the nerve roots that cause pain. Radiosurgery is an invasive procedure that uses radiation rays to destroy some trigeminal nerve fibers that produce pain.

What will happen after the operation?

After performing surgery and waking up, you will be treated in an ICU room, after surgery you will feel headache, nausea and vomiting. Once you recover you will return to the nursing home for one to two days.

Discomfort to be felt:

  • After performing a craniotomy action, you will feel a headache, the pain after this operation can be reduced by the consumption of narcotic drugs within a certain period of time. In addition, the use of these drugs can also cause constipation, so multiply consume water and foods that contain lots of high fiber, laxatives (dulcolax, senokot, milk, and foods containing magnesia).
  • Ask your surgeon before taking any anti-inflammatory nonsteroid medications such as aspirin, ibuprofen, advil, motrin, nuprin, naproxen sodium, and aleve. This is because these drugs can cause bleeding and interfere with bone recovery.

Abstinence

  • Must not drive a car until it is discussed with a neurosurgeon and avoid sitting too long.
  • Avoid lifting heavy items including lifting a small child
  • Avoid housework including gardening, cutting, vacuuming, ironing, washing dishes, and washing clothes with a washing machine.
  • Avoid drinking alcohol

Activity

  • Periodically, your condition will return to normal, but fatigue will remain.
  • Stretch your back neck slowly.
  • Begin learning to walk slowly and increase the distance, and discuss with your surgeon to follow a therapy that can increase your activity.

Call a Doctor If you feel something like the following:

  • If you have a fever of up to 38 ° C
  • The emergence of infection in the incisory areas, such as the appearance of redness, bengakak, pain.
  • If you are using anti-convulsive medications and cause drowsiness, imbalance, or rashes.
  • Reduced vigilance, drowsiness, weakness of the arm or leg, headache, vomiting, or severe neck pain that can lower your chin to the chest.

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