Download - Neuralgia Trigeminal TRIAS
![Page 1: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/1.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 1/18
Neuralgia TrigeminalNeuralgia Trigeminal
Oleh:
Dennis 07200Laurencia F.R.S. 072011101043
SMF.Ilmu Penyakit Saraf
RSUD dr. Soebandi
Pembimbing : dr. H. Eddy A.K Sp.S
![Page 2: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/2.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 2/18
ANATOMIANATOMI
![Page 3: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/3.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 3/18
![Page 4: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/4.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 4/18
![Page 5: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/5.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 5/18
Neuralgia
DefinisiDefinisi
neuralgia adalah nyeri yg dirasakan pd daerah distribusi
saraf.
![Page 6: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/6.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 6/18
EtiologiEtiologi
y Insidens 4,3 per 100.000 populasi /tahun
y Perempuan > laki: 1,17 : 1
y
Sering pada usia dewasa set
elah 40t
hn,ditemukan
juga pada anak usia 12 thn.
y Presipitasi mengunyah, menggigit,kontak
pada daerah trigger zone.
![Page 7: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/7.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 7/18
EtiologiEtiologi««««««««««
![Page 8: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/8.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 8/18
Neuralgia Trigeminal
Keadan nyeri saraf yg ditandai:
Serangan paroksismal
Tajam & hebat
pd daerah percabangan n .V
berlangsung bbrp detik
sampai menit
disertai gangguan sekretoris
dan vasomotor
dpt dipicu oleh:
saat sikat gigi,mencuci muka,
mengunyah,
kena angindingin
![Page 9: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/9.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 9/18
PATOFISIOLOGIPATOFISIOLOGI
y iritasi kronis pada saraf ini kegagalan pada
inhibisi segmental pada nukleus/ inti saraf ini
yang produksi ectopic action potential padasarafTrigeminal discharge neuronal yang
berlebihan dan pengurangan inhibisi
mengakibatkan jalur sensorik yang hiperak tif
serangan nyeri
![Page 10: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/10.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 10/18
MANIFESTASI KLINISMANIFESTASI KLINIS
chueditingC
timbul setelah umur 40 th
Intensitas nyeri yg
tinggi di trigger point
(cuping hidung, mulut )
Nyeri 20 30 detik ,
hilang kemudian
timbul lagi.
Unilateral,
kanan lebih sering
Cabang 2 atau 3 adalah yg
plg sering terkena Dapat disertai spasme
wajah sesisi
Pem neurologis hampir
selalu normal
Pd N.T bilateral
sering pd multiple
sklerosis
![Page 11: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/11.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 11/18
![Page 12: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/12.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 12/18
![Page 13: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/13.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 13/18
DIAGNOSISDIAGNOSIS
Tidak ada pem penunjang yang khas
Anamnesa & klinis yg baik dan lengkap
Untuk neuralgia simptomatis, harus dicurigaiadanya multiple skelerosis, sehingga perludilakukan pemeriksaan likuor dan evokedpotensial.
Bila penyebabnya tumor fossa posterior , perludilakukan foto kepala (skul foto), CT scanatau MRI
![Page 14: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/14.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 14/18
AnamnesaAnamnesa
y Lokasi nyeri, untuk menentukan cabang
nervus trigeminus mana yang terkena
y Menentukan wak tu dimualinya neuralgia
trigeminal dan mekanismue pemicunya
y Menentukan interval bebas nyeri
y Menanyakan riwayat penyakit herpes
![Page 15: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/15.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 15/18
Pemeriksaan fisik Pemeriksaan fisik
y Menilai sensasi pada ketiga cabang nervus
trigeminus bilateral
y Menilai fungsi mengunyah (m.masseter)
dan fungsi m.pterygoideus (membuka
mulut dan deviasi dagu)
![Page 16: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/16.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 16/18
TERAPITERAPI
1. Medikamentosa
a. Carbamazepin : 200-1200 mg/hari
b. Baclofen : 60-80 mg/hari2. Pembedahan
![Page 17: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/17.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 17/18
DIAGNOSA BANDINGDIAGNOSA BANDING
1. Glossopharyngeal neuralgia
2. Migran
3. Cluster headache
4. Post herpetic neuralgia
5. Nyeri pada sinusitis
chueditingC
![Page 18: Neuralgia Trigeminal TRIAS](https://reader030.vdocuments.net/reader030/viewer/2022020715/5571fe9e49795991699bc7a5/html5/thumbnails/18.jpg)
5/12/2018 Neuralgia Trigeminal TRIAS - slidepdf.com
http://slidepdf.com/reader/full/neuralgia-trigeminal-trias 18/18
PROGNOSISPROGNOSIS
Ad Bonam