[Clinical and therapeutic aspects of trigeminal neuralgia. Apropos of 27 cases treated at the General Hospital of Grand-Yoffin Dakar]

Abstract

The trigeminal neuralgia or "painful tic" of the face is an invalidating affection, which affects the quality of life of the patient. The odontologist must be able to diagnose it and take part in his good therapeutic assumption of responsibility. The diagnosis is sometimes difficult, being able to involve unsuited therapeutic methods prejudicial for the patient. The objective of our study was to analyse the clinical and therapeutic aspects of the trigeminal neuralgia. It was a transverse and descriptive study which 27 files of patients suffering of trigeminal neuralgia and treated in the odontology service of the General hospital of Grand-Yoff in Dakar between July 2002 and July 2008. We exploited the following parameters: the age, the sex, the oral state, duration of the symptoms, characteristics of the pain, the type of treatment. 22 patients of the 27 cases were female. The time of consultation was often late, the patients generally preferring begin with the traditional treatments. The neuralgia of V2 dominated the clinical picture, followed that neuralgia of V3. The pain was strictly unilateral, it was started by movement, speaking, eating or touching the trigger zone. The prescription of carbamazepine (Tegretol) was systematic, and constituted a true test diagnosis, it made possible to obtain an immediate sedation of the pains. In front of the medicamentous treatment failure, the alcoholization of the trigeminal branch has given good performances, indeed it made possible to obtain, a clear lull of more than 12 months for 9 patients out of the 10 who profited from it. The alcoholization of the trigeminal nerve remains an effective cure and constitutes an accessible alternative under our work conditions in Africa.