Diseases of nerves and muscle

• disturbances of fifth cranial nerve

  Trigeminal Neuralgia

  Paratrigeminal Syndrome

  Sphenopalatine Neuralgia

  Burning Mouth Syndrome

  Orolingual Paresthesia

  Auriculotemporal Syndrome
• Variant of Trigeminal Neuralgia (TN)

  trifacial neuralgia, Fothergill's disease, tic douloureux
• Mainly affects the second and third division

  Trigeminal Neuralgia (TN)
• involves orofacial neuralgias, paroxysmal of pain, and most likely not in dental origin

  Trigeminal Neuralgia (TN)
• Etiology of Trigeminal Neuralgia (TN),

  • peripheral injury to the nerve
  • idiopathic
  • tumors, multiple sclerosis
• Clinical features of Trigeminal Neuralgia

  • Older adults (age 35 and above) and Female Right side of the face 'trigger zone'

  tic duoloureux Pretrigeminal Neuralgia
• Trigeminal Neuralgia Differential Diagnosis

  • Horton’s Syndrome
  • Trotter’s Syndrome
  • Postherpetic Neuralgia
  • Costen Syndrome
• Migrainous neuralgia

  Hosrton’s Headache
• Has periodic headache, last over a period of hours, and has no ‘trigger zone’

  Horton’s Syndrome
• Nasopharyngeal tumor

  Trotter’s Syndrome
• involves conductive deafness, trigeminal neuralgia, and palatal palsy

  Trotter’s Syndrome
• attacks of herpes zoster of the fifth nerve

  Postherpertic Neuralgia
• Sinusitis

  Costen Syndrome
• Variant of Paratrigeminal Syndrome

  Raeder's syndrome, paratrigeminal neuralgia
• severe headache or pain in the area of the trigeminal distribution

  Paratrigeminal Syndrome
• Hemolateral pain in the head or eye and Occur without vasomotor or trophic disturbances

  Paratrigeminal Syndrome
• rare condition classically presenting with partial ptosis (drooping or falling of the upper eyelid), miosis (constricted pupil), and facial anhidrosis (absence of sweating) due to a disruption in the sympathetic nerve supply.

  Horner’s syndrome
• Paratrigeminal Syndrome is also associated with horner’s syndrome
• Variant of Sphenopalatine Neuralgia

  Sluder's headache, Horton's syndrome, periodic migrainous neuralgia, vidian neuralgia
• A symptom complex referable to the nasal ganglion

  Sphenopalatine Neuralgia
• recurrent brief attachs of sudden, severe, unilateral periorbital pain

  Sphenopalatine Neuralgia
• Etiology of Sphenopalatine Neuralgia

  • hypothalamic hormonal influences
  • idiopathic
• Clinical features of Sphenopalatine Neuralgia

  • unilateral paraxysms of intense pain
  • Rapid onset
  • no ‘trigger zone”
  • Men- before the age of 40 years
• A burning or stinging of the mucosa, lips and/or tongue, in the absence of visible mucosa lesion.

  Burning Mouth Syndrome
• Local causes of Burning Mouth Syndrome

  • Dry mouth Mucosal disorders - geographic tongue, lichen planus
  • Trauma to oral mucosa Repetitive oral habits (tongue trusting)
  • Gastroesophageal reflux disease
  • Sensory nerve damage
• Systemic medical causes of Burning Mouth syndrome

  • Vitamin B12, folate, iron deficiency
  • Medications
  • Immunologically-mediated disease
  • Psychogenic disorders Psychosocial stresses
  • Diabetes mellitus
  • Menopause
• Clinical Features of burning mouth syndrome

  • continuous or intermittent burning sensation
  • affects the tongue-sometimes the lips or palate
  • no oral mucosal lesions sensation of dry mouth-increased thirst
  • Anxiety or depression
• variant of orolingual paresthesia

  Glossodynia, Glossopyrosis
• Parenthesia of the oral mucous membrane

  and a symptom rather than a disease entity

  Orolingual Paresthesia
• Local and systemic causes of Orolingual Paresthesia

  • Deficiencies
  • Diabetes
  • Gastric disturbances
  • Psychogenic factors
  • Trigeminal Neuralgia
  • Periodontal disease
  • Xerostomia
  • Hypothyroidism
  • Referred pain
  • Angioneurotic edema
  • Mercurialism
  • Moeller's glossitis
  • Oral habits (tobacco use) Antibiotic therapy
  • Local dental causes (dentures, irritating clasps, or new fixed bridges)
• clinical features of orolingual paresthesia

  • Affects the tongue- or any site of the oral cavity may be affected
  • pain, burning, itching and stinging of the mucous membrane
  • women-past the menopause, rare in children
• Variant of Auriculotemporal Syndrome

  Frey's syndrome, Gustatory sweating
• a result of damage to the auriculotemporal nerve and subsequent reinnervation of sweat glands by parasympathetic salivary fiber

  Auriculotemporal Syndrome
• etiology of Auriculotemporal Syndrome

  • surgical operation (removal of tumor or the ramus of the mandible)
  • transaxional excitation
• Clinical Features of Auriculotemporal Syndrome

  • flushing andsweating (on the side of face , chiefly temporal area, during eating)
  • Crocodile Tears
• DISTURBANCES OF 7TH CRANIAL NERVE

  Bell’s Palsy
• one of the most common neurologic disorders affecting the cranial nerves.

  Bell’s palsy
• It is an abrupt, isolated, unilateral, peripheral facial nerve paralysis without detectable causes.

  BELL'S PALSY
• the most common cause of facial paralysis worldwide

  BELL'S PALSY
• Bell’s palsy is considered an idiopathic facial paralysis;