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History Stations
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
Trigeminal neuralgia causes severe, sharp shooting pain in the distribution of the maxillary or mandibular divisions of the trigeminal nerve. It is typically unilateral and short lived but recurrent and can be induced by factors such as light touch, eating or exposure to cold air. They may have autonomic features such as lacrimation, conjunctival injection, nasal congestion, rhinorrhoea, ptosis or diaphoresis. Treatment is performed with the anticonvulsant medication carbamazepine.
Facial anatomy
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
The trigeminal nerve is the fifth cranial nerve and has the following sensory and motor functions: Sensory innervation to the skin, mucous membranes and sinuses of the faceMotor function is derived solely from the mandibular branch of the trigeminal nerve which innervates the muscles of mastication, namely the masseter, temporalis, and medial and lateral pterygoid muscles The origin of the trigeminal nerve can be appreciated as a confluence of three sensory nuclei: the mesenteric nucleus from the midbrain, the principal sensory nucleus of the pons and the spinal nucleus of the medulla oblongata. These three nuclei combine within the pons to create the trigeminal nerve root. The smaller motor nerve root also arises from the pons and can be found directly inferior to the trigeminal nerve root.
Dizziness
Published in Henry J. Woodford, Essential Geriatrics, 2022
Cerebellopontine angle tumours (e.g. acoustic neuroma) usually present with unilateral sensorineural hearing loss due to compression of the eighth nerve. The trigeminal nerve may also be affected causing facial numbness and loss of the corneal reflex. When vertigo occurs, it is usually a late feature.
Evaluating the perioperative analgesic effect of ultrasound-guided trigeminal nerve block in adult patients undergoing maxillofacial surgery under general anesthesia: A randomized controlled study
Published in Egyptian Journal of Anaesthesia, 2023
Maha Misk, Abdelrhman Alshawadfy, Medhat Lamei, Fatma Khames, Mohamed Abd Elgawad, Hamdy A. Hendawy
The trigeminal nerve mediates both sensory and motor innervation to the maxillofacial region. It is divided into ophthalmic, maxillary, and mandibular branches. The sensory divisions of these branches travel to their cell bodies in the trigeminal or Gasserian ganglion found at the floor of the middle cranial fossa. From the Gasserian ganglion, the sensory nerve fibers synapse with the trigeminal nuclei in the brainstem [18,19]. Nader et al. [9] demonstrated that infusing just 2 mL of contrast dye into the pterygopalatine fossa under fluoroscopy guidance caused a backward flow of contrast into the middle cranial fossa and enabled the observation of the Gasserian ganglion. They attributed the dye’s retrograde spread to the small size of the pterygopalatine fossa and its connection to the middle cerebral fossa via the foramen rotundum. The USGTNB via pterygopalatine fossa was carried out in patients who had facial pain by injecting 4 ml of 0.25% bupivacaine [20]. The long acting anesthetic bupivacaine has been used for many years in nerve block procedures. Recent studies [21,22] have used bupivacaine alone to effectively manage trigeminal nerve pain. Nader and Kendall [23] assessed the effectiveness and safety of USGTNB using bupivacaine in patients with facial pain. Within 10 min of injection, 80% of the patients experienced complete sensory analgesia in one side of the face. In addition, the patients did not show any neurological adverse effects from the block after being observed for 6–12 months.
Neurological manifestations of SARS-CoV-2 infections: towards quantum dots based management approaches
Published in Journal of Drug Targeting, 2023
Faezeh Almasi, Fatemeh Mohammadipanah
Part of the PNS is the set of 12 paired cranial nerves directly connected to the brain. One of the main cranial nerves controlling the sensory functions of the face is the trigeminal nerve. There are reports presenting the RNA fragments of SARS-CoV-2 in this sensory nerve indicating the probable transfer of SARS-CoV-2 to CNS via the trigeminal nerve. It is also proposed that SARS-CoV-2 spread to the medullary cardiorespiratory centres after lung infection through the mechanoreceptors of the vagus nerve, the longest nerve of cranial nerves [93]. It has been reported that other respiratory viruses, like influenza, can enter the CNS via the sensory vagus nerve [61]. Moreover, some reports demonstrate the infection of peripheral nervous gastrointestinal systems by SARS-CoV-2 [94].
Persistent Trigeminal Artery Causing an Abducens Nerve Palsy: A Case Report
Published in Neuro-Ophthalmology, 2023
Aimee Lloyd, Sunila Jain, Diana Duke, Somenath Chatterjee, Bahauddin Ibrahim
One of the more commonly documented effects of PTA is trigeminal neuralgia. The reported link between PTA and trigeminal neuralgia is based on its anatomical location. The PTA was given its name due to its proximity to the Gasserian ganglion and trigeminal nerve.16 If the trigeminal artery fails to regress, it can cause compression of the trigeminal nerve leading to neuralgia symptoms.16 Kempe and Smith found that a PTA could displace and compress the trigeminal sensory nerve root.17 De Bondt et al. examined MRI studies from 136 patients presenting with trigeminal neuralgia and found that a PTA was present in 2.2%.18 The reported rate of an incidental finding of PTA is 0.1–0.6% on cerebral angiography.4 The prevalence rate found in the de Bondt et al. study of 2.2% is therefore clinically significant, and they concluded by recommending a cerebral MRI or angiogram for patients presenting with trigeminal neuralgia as a non-invasive way to aid the diagnosis.18