A CASE OF TRIGEMINAL

NEURALGIA
 PARTICULARS OF THE PATIENT
• Name: Sumanlata.
• Age: 40yrs.
• Sex: Female.
• Religion : Hindu.
• Occupation: Housewife.
• Residence: B-78, Nayi Colony, Near
Kasampur Pump House, Aligarh.
• Date of OPD Attendance: 29.5.2010 – 14.8.10
• Chief Complaints: Sharp, intense, momentary
pain on right side of face for past three and
half months.

• Other Complaints: Insignificant

 History of Present Illness
• According to patient she was well before three
and half months. Then she suddenly felt pain
on right face which was sharp, intense and
momentary in nature and aggravated on
chewing and speaking.
• She had badly carious 16 which was removed 1
month back. Meanwhile she went for ENT,
ophthalmology and neurology consultation but
didn’t get relief.
 History of Past Illness
• She has been hospitalized for hysterectomy
procedure for one week in February this year
and discharged with uneventful healing.
 Personal History
• She has normal bowel and bladder habits and
normal sleep and appetite.
 Medical History
• Insignificant
 Drug Allergy
• Insignificant.
 Examination
• General examination-
• Patient is conscious and cooperative and well
oriented to time place and person.
• No pallor, no cyanosis, no jaundice, no
lymphadenopathy.
 Extra-oral Examination
• Facial form and symmetry is normal, no
swelling ,sinus or discoloration is present.
• Ipsilateral lymph node is palpable but not
tender.
• Mouth opening is 4.5 cm.
• Jaw movements are noramal.
 Intraoral Examination
• Dentition is normal, occlusion is normal.

• Oral mucosa is normal.

• Absent tooth 16
 Investigations
• Hb- 10 mg%
• TLC- 9600/cumm.
• Neutrophils- 58%
• Lymphocytes- 37%
• Eosinophils- 4%
• Basophils- 1%
 MRI
• MR image is suggestive of normal study.
 Differential Diagnosis
• Odontogenic Pain

• Migraine

• Post herpetic Neuralgia

• Cluster Headache
 Diagnosis
• Trigeminal Neuralgia
 Treatment Plan
• Medical Management.
• Tab Tegretol 200mg bd
• 14.8.10- tab Tegretol 200mg tds

• Complain of nausea, vomiting, drawsiness

with tegretol.
• Adv liver function tests-
• 21.8.10-Tab Eptoin 100mg 3HS.
• 26.8.10 –No relief
• Alcohol nerve block IO and IAN given.

• Advice – MRI cranium.

• 28.8.10- Marked pain relief.

• 5.10.10 -Patient get complete pain relief

• Tab Tegretol CR 1OD
• Cap Becosules 1OD For 1 month.