Trigeminal neuralgia physical examination: Difference between revisions
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== Physical Examination == | == Physical Examination == | ||
The physical examination in patients with trigeminal neuralgia is generally normal. Therefore, physical examination in patients with facial pain is most useful for identifying abnormalities that point to other diagnoses. The physician should perform a careful examination of the head and neck, with an emphasis on the neurologic examination. The ears, mouth, teeth, and temporomandibular joint (TMJ) should be examined for problems that might cause facial pain. | The physical examination in patients with trigeminal neuralgia is generally normal. Therefore, physical examination in patients with [[facial pain]] is most useful for identifying abnormalities that point to other diagnoses. The physician should perform a careful examination of the head and neck, with an emphasis on the neurologic examination. The ears, mouth, teeth, and [[temporomandibular joint]] (TMJ) should be examined for problems that might cause facial pain. | ||
The finding of typical trigger zones verifies the diagnosis of trigeminal neuralgia. Patients with classical trigeminal neuralgia have a normal neurologic examination. Sensory abnormalities in the trigeminal area, loss of corneal reflex, or evidence of any weakness in the facial muscles should prompt the physician to consider secondary trigeminal neuralgia or another cause of the patient's symptoms.<ref>RUDOLPH M. KRAFFT, MD, Northeastern Ohio Universities College of Medicine, Rootstown, Ohio | The finding of typical trigger zones verifies the diagnosis of trigeminal neuralgia. Patients with classical trigeminal neuralgia have a normal neurologic examination. Sensory abnormalities in the trigeminal area, loss of [[corneal reflex]], or evidence of any weakness in the facial muscles should prompt the physician to consider secondary trigeminal neuralgia or another cause of the patient's symptoms.<ref>RUDOLPH M. KRAFFT, MD, Northeastern Ohio Universities College of Medicine, Rootstown, Ohio | ||
Am Fam Physician. 2008 May 1;77(9):1291-1296.</ref> | Am Fam Physician. 2008 May 1;77(9):1291-1296.</ref> | ||
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* Age younger than 40 years | * Age younger than 40 years | ||
* Bilateral symptoms | * Bilateral symptoms | ||
* Dizziness or vertigo | * [[Dizziness]] or [[vertigo]] | ||
* Hearing loss or abnormality | * [[Hearing loss]] or abnormality | ||
* Numbness | * [[Numbness]] | ||
* Pain episodes persisting longer than two minutes | * Pain episodes persisting longer than two minutes | ||
* Pain outside of trigeminal nerve distribution | * Pain outside of trigeminal nerve distribution | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Needs content]] | [[Category:Needs content]] | ||
[[Category:Neurosurgery]] | [[Category:Neurosurgery]] | ||
[[Category:Pain]] | [[Category:Pain]] | ||
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[[Category:Rare diseases]] | [[Category:Rare diseases]] | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
Latest revision as of 00:29, 30 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Signs of trigeminal neuralgia can be seen in males who may deliberately miss an area of their face when shaving, in order to avoid triggering an episode. Although trigeminal neuralgia is not fatal, successive recurrences may be incapacitating, and the fear of provoking an attack may make sufferers reluctant to engage in normal activities.
Physical Examination
The physical examination in patients with trigeminal neuralgia is generally normal. Therefore, physical examination in patients with facial pain is most useful for identifying abnormalities that point to other diagnoses. The physician should perform a careful examination of the head and neck, with an emphasis on the neurologic examination. The ears, mouth, teeth, and temporomandibular joint (TMJ) should be examined for problems that might cause facial pain.
The finding of typical trigger zones verifies the diagnosis of trigeminal neuralgia. Patients with classical trigeminal neuralgia have a normal neurologic examination. Sensory abnormalities in the trigeminal area, loss of corneal reflex, or evidence of any weakness in the facial muscles should prompt the physician to consider secondary trigeminal neuralgia or another cause of the patient's symptoms.[1]
Here are some atypical features in the physical examination that can point towards diagnosis other than trigeminal neuralgia:
- Abnormal neurological examination
- Abnormal oral, dental, or ear examination
- Age younger than 40 years
- Bilateral symptoms
- Dizziness or vertigo
- Hearing loss or abnormality
- Numbness
- Pain episodes persisting longer than two minutes
- Pain outside of trigeminal nerve distribution
- Visual changes
References
- ↑ RUDOLPH M. KRAFFT, MD, Northeastern Ohio Universities College of Medicine, Rootstown, Ohio Am Fam Physician. 2008 May 1;77(9):1291-1296.