Radiofrequency Percutaneous Gasserian Ganglion Surgery
Trigeminal neuralgia in its pure form consists of severe paroxysmal pain localized to the sensory domain of the trigeminal nerve uniformly induced by stimuli to the sensory endings of the trigeminal nerve. The pain begins abruptly, lasts seconds to minutes, and ends as suddenly as it began having varying pain-free intervals between paroxysms. There are several avenues of approach for amelioration of this pain. Firstly, a history and neurological examination are done to rule out the possibility of a mass lesion as the cause of trigeminal neuralgia. Sensation in the distribution of the fifth cranial nerve should be tested. The pin is appreciated in this patient as sharp on the right and over the third division on the left. The pin not only is appreciated as sharp in the left second and first divisions but also provokes typical paroxysms of the patient’s pain. Touch similarly causes pain. Fifth cranial motor function, including temporalis and pterygoid, is tested. The presence of numbness or motor weakness should alert the physician to the likely presence of a mass involving the posterior root or the gasserian ganglion. Corneal sensation is checked. Some of the maneuvers that precipitate pain are demonstrated.
KeywordsTrigeminal Nerve Trigeminal Neuralgia Corneal Ulceration Posterior Root Superior Orbital Fissure
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