- Pain is felt on the skin, not on the structure of a deeper, more serious in the peripheral area of the distribution of the affected nerve, namely; on the lips, chin, nostrils, and the teeth.
- Paroxysm stimulated by stimulation of the terminal branches of the nerve are affected, ie washing the face, shaving, brushing teeth, eating and drinking.
- Cold air flow and direct pressure on the nerve trunk can also cause pain. This happens because the cold air flow on the trigger area or pain in the branching area of the trigeminal nerve (fifth cranial nerve). Cold air flow including a non-noxious stimulus (stimulus in the form of a light touching, vibration or stimulus chewing).
- Point originator is certainly an area where the lightest touch immediately trigger paroxysm.
Signs and Symptoms of Trigeminal Neuralgia According (Olesen, 1988; Passon, 2001; Sharav, 2002; Brice, 2004)
- Pain such as neuropathic pain, namely; paroxysmal severe pain, sharp, like a stabbed, shot, electrocuted, struck by lightning, or burning that brief few seconds to several minutes but less than two minutes, sudden and repetitive. Among the attacks is usually a pain-free interval, or only a mild dull taste.
- The location of pain is generally limited in the area of the trigeminal nerve dermatome, and the characteristics of unilateral pain. Common pain in the area of the mandibular nerve distribution (V2) of 19.1% and maxillary nerve (V3) 14.1% or a combination of both 35.9% so that the most frequent pain in the lower half of the face. Rarely confined to the ophthalmic nerve (V3) of 3.3%. Most patients felt pain throughout the branches of the trigeminal nerve (15.5%) or a combination of maxillary and ophthalmic nerve (11.5%). Rare combination of pain in the ophthalmic and mandibular nerve distribution (0.6%). 3.4% bilateral pain, pain rarely felt on both sides simultaneously, generally between the two sides are separated several years. Bilateral cases are usually associated with multiple sclerosis, or familial.
- Trigeminal neuralgia can be triggered by non-noxious stimuli such as light touching, vibration, or chewing stimulus. As a result, the patient will have difficulty or raised when brushing teeth, eating, swallowing, speaking, touched the face, wash the face even the cold wind blown. Usually the area that can trigger pain (triger area) diwajah the front, one side with pain in the same branch of the trigeminal nerve. When triger area of the scalp area, patients are afraid to wash or comb.
- Approximately 18% of patients with trigeminal neuralgia, initially, atypical pain which longer be typical, so-called pre trigeminal neuralgia. Pain is dull, constantly on one jaw that lasts a few days to several years. Thermal stimulus can cause throbbing pain that is often regarded as dental pain. Anticonvulsants therapy can relieve pain of trigeminal preneuralgia so this method can be used to distinguish both the pain.
- On physical and neurologic examination is usually normal or not found significant neurologic deficit. The loss of sensibility that is meaningful to the trigeminal nerve leads to finding the underlying pathological process, such as a tumor or infection that can damage the nerves. In the atypical tumor in addition to the pain and loss of sensibility, accompanied other cranial nerve irritation.
