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Painful Trigeminal Neuropathies - Coggle Diagram
Painful Trigeminal Neuropathies
Terminology
Alloydina
- pain in response to a stimulus which would not normally cause pain
Hyperalgeasia
- increased response to a stimulus which would normally cause pain
Hyperaesthesia
- increased mucosal sensitivity to a stimulus
Dysesthesia
- unpleased or abnormal sensation affecting the skin/mucosa
Hypoalgesia
- reduction in response to stimulus which would normally cause pain
Painful Trigeminal Neuropathies attributed to the HSV
Unilateral facial pain in one or more of the branches of the trigeminal nerve
lasts <3 months
associated with clinical signs/symptoms of acute herepes zoster virus
Trigeminal Post-Herpetic Neuralgia
Presentation
Unilateral facial pain in 1 or more of the distributions of the branches of the trigeminal nerve
lasts <3 months
variable sensory changes
pain
background burning ache - PREDOMINANT TYPE
sharp/shooting pain - not predominant type. Distingushes from trigeminal neuralgia
Prevention
Associated with Herpes Simplex Viral Investion
Prevent infection with shingles vaccine (Herpes zoster) in 70-79 year olds
Prevent post herpetic neuralgia with
antivirals within 72hrs shingles dx
Management
Immediate management
Painkillers - paracetamol and codeine
Self management
Relaxation
Distraction
Mindfullness
exercise
Topical Management
Capsasin cream/patches
Lidocaine patches
Systemic Management
Duloxetine
Amytriptyline
Painful Post-Traumatic Trigeminal Nerupathy
history of an identifiable traumatic event to the trigeminal nerve with positive (hyperalgesia/allodyina) or negative (hypoalgesia or hypoaesthesia) trigeminal dysfunction
Pain
localised to the distribution of the trigeminal nerve affected by traumatic event
pain developed <6 months after traumatic event
not accounted for by another ICHD-3 disease