Trigeminal Neuralgia Flashcards Preview

External medicine > Trigeminal Neuralgia > Flashcards

Flashcards in Trigeminal Neuralgia Deck (41):
1

which TCM category?

facial pain and temporal headache

2

Which nerve is affected?

cranial nerve 5- sensory fx

v1-eye
v2-upper jaw/nose
v3-lower jaw

V2/3 most common

3

triggers:

facial massage, cold drinks, touch
fall/spring time
zone: corner of mouth/nose

4

common western drug:

1) carbamazepine
2) baelofen
3) phenytoin

5

etiology

1) W-C--------------------------\
2) emotions \
3) diet \
4) febrile disease SHI
5) excessive sexual activity-----/
6) long term illness---XU
7) constitution--------/

6

Patterns

1) W-C
2) Damp-heat in LIV/GB
3) ST-fire
4) obstruction by W-PH
5) blood stg
6) Qi and blood xu
7) flare up of XU fire

7

Burning pain on face and cheek and gum, aggravated by heat, redness of face and eyes, dryness of mouth, halitosis, constipation, dark yellow urine

Flare up of ST fire

8

flare up of ST fire T/P:

T- red, yellow coat
P- slippery, rapid, flooding

9

dull pain, numbness of the face, heaviness and cloud of head, stuffy sensation in chest, too much sputum, numbness of face

Obstruction by W-PH

10

obstruction by W-PH T/P:

T- puffy, white sticky coat
P- wiry, slippery

11

recurrent dull or hollow pain, severe in stand up, mild when lie down, aggravated by overwork, pale face, fatigue, SOB, poor appetite

Qi and blood xu

12

QI and blood xu T/P

T- pale, white coat
P- thready

13

acute onset, severe contract pain which is alleviated by warmth aggravated by W-C, aversion to W-C, headache, running nose

Invasion W-C

14

Invasion W-C T/P:

T- thin white coat
P- floating, light

15

dull distension pain, tic or numbness of the face, aggravated by anger, insomnia, poor memory, soreness and weakness of lumbar

flare up of XU fire

16

flare up of XU fire T/P:

T- red, little/no coat
P- thready and rapid

17

recurrent fixed stabbing pain, severe at night, numbness after pain, dull face

blood stg

18

blood stg T/P:

T- dark purple, petechiae, thin white coat
P- wiry, tight, choppy

19

paroxysmal burning pain, referred to the corner of the head, frequently precipitated by emotional frustration, irritability, redness of face and eyes, bitter taste

D-heat in LIV/GB

20

D-heat in LIV/GB T/P:

T- red tip/edges, yellow sticky coating
P- wiry, rapid

21

blood stg points

SP-10, UB-17

22

DX:

1) 40+
2) sudden lightning like paroxysmal pain in 1 or more branches of 5th cranial nerve
3) trigger points- around mouth

23

differentiate:

1) toothache
2) migraine (4 stages- preheadache, neuralgia stage, headache, postheadache)
3) cluster headaches

24

Qi and blood xu points

ST-36, RN-6

25

invasion W-c points

LI-4, GB-20

26

obstruction w-PH points

ST-40, GB-20

27

D-heat in LIV/GB points

GB-20, LIV-3

28

flare up ST-fire points

ST-44, LI-11

29

flare up XU fire points

K-3, SP-6

30

definition:

sudden, lightning-like paroxysms of pain in the distribution of one or more divisions of the trigeminal nerve due to primary and secondary injuries of the nerve.

31

SHI VS XU:

SHI VS XU
acute, severe chronic, dull
distending, burning pain constant, hollow pain
short duration long duration
less frequent more frequent
contracting pain lingering pain

32

which patterns are the most common in clinic?

1) W-C
2) D-heat in LIV/GB
3) flare up XU fire
4) blood stg

33

POT:

circ. collaterals, move blood to stop pain

34

severe case tx:

long retention (1 hour)

35

which meridians affected?

yangming
shaoyang

36

common points:

general: ST-7, SI-19, ashi
distal: LI-3/4, SJ-3/5, ST-44, Liv 3
local: opthalmic branch (eye): UB-2, GB-14, yuyao
maxillary branch (nose): ST-2/3, SI-18
mandibular branch: jia cheng jiang, ST-4/5/6

37

ALT remedies:

*acute treat twice a week*
Retain needle 30 min

1) moxa (cold)
2) electro: mixed wave (200/50 Hz= SHI, 25/5 Hz= XU) 10-15 min
*for during the attack only!!(cant trigger attack during remission)
3) herbs
4) auricular (bleed ear apex first, temple, forehead, jaw, shenmen, sympathetic, subcortex, LIV, SP, ST)

38

EDU:

1) avoid EPF
2) reg. emotions
3) reg. sexual activity
4) reg. diet

39

V1 points

Yuyao
St 8
SJ 23
GB 14
UB 2

40

V2 Points

ST 2/7
SI 18
LI 20

41

V3 Points

Jia Cheng Jiang
ST 4/5/6