Trigeminal Neuralgia in Elderly

Abstract

Orofacial pain is often the reason patients visit general practitioners, one of which is trigeminal neuralgia. Trigeminal neuralgia is one of the most painful neurological conditions and is often described as a 'storm' that sticks in the face or a stabbing sensation in the face. The analysis of this study is a case report. Mr. YW, 67 years old, came to the Neurology Polyclinic with complaints of pain in the left jaw since 1 day before entering the hospital. Initially, the patient complained of pain in the left jaw since 7 years ago. The pain is felt like being stabbed and felt in the left cheek area, radiating to the lower left jaw continuously, and gets worse when parts of the jaw are moved, such as when chewing, speaking, and when given a soft touch. On neurological examination, abnormalities were found in the Trigeminal Nerve (V) with hypersensitivity that felt like being stabbed and burned in the trigger zone area, precisely in the left mandible, other neurological conditions were within normal limits. The patient was diagnosed with all three diagnoses in neurology. First, facial pain (neuralgia) is a clinical diagnosis, Trigeminal Nerve (V) left ramus maxilla and mandible is a topic diagnosis, and Trigeminal Neuralgia is an etiological diagnosis. The patient was given medical treatment in the form of Karbamazepin 2x200 mg, Amytriprilin 1x12.5 mg, and Ibuprofen 3x200 mg, as well as non-medical management in the form of educating patients and families about the disease and the treatment to be given. The prognosis for this case includes quo ad vitam dubia ad bonam, quo ad functionam dubia ad malam, and quo ad sanationam dubia ad bonam.