Zahoor Ahmed Rana, Arshad Mahmood Malik, Iffat Zahoor Rana.
Aggravating and relieving factors in Trigeminal neuralgia: PIMS Experience.
Ann Pak Inst Med Sci Jan ;1(1):32-6.

Back Ground: Pain is a perplexing problem confronting all who practice in the art of healing. Severe pains of different origins in the oral & maxillofacial region are well known to physicians but among the idiopathic pains the trigeminal neuralgia is the most notorious one. Objective: This study was conducted to evaluate the aggravating, relieving factors, and to educate the patients and treating physicians Material and Method: We evaluated consecutive 50 patients in Oral and Maxillofacial surgery Department of Pakistan Institute of Medical Sciences, Islamabad Patients categorized in four groups, G-0 stimulation of skin, G-1 for Masticatory movement, G-2 for phonetics and G-3 for environmental thermal changes. Results: The aggravating and relieving factors were found almost in each case, such as touch, eating, shaving, brushing, washing sleep and local anesthesia etc. These factors either exist alone or in combination with other aggravating and relieving factors. The diagnosis was made on the basis of history, clinical features and by observing the various aggravating and relieving factors. Patients were educated and made aware of these factors, to avoid nerve stimulation. Conclusion: It was found that patients get dramatic improvement of this notorious problem.

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