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Glossary

Based on the glossaries in the books, Striking Back! The Trigeminal Neuralgia and Face Pain Handbook by George Weigel and Dr Ken Casey, and Insights – Facts and Stories behind Trigeminal Neuralgia by Professor Joanna Zakrzewska, and the Dorland Illustrated Medical Dictionary. 

ablative
removal , separation or cutting of a structure

acoustic neuroma
a tumor growing on the acoustic or hearing nerve. This can sometimes cause TN when the nearby tumor pushes a blood vessel onto the trigeminal nerve

adhesions
fibrous growths similar to scar tissue that form at the site of tissue damage.

allodynia
pain due to a stimulus which does not normally provoke pain

analgesics
medications that relieve pain

anesthesia dolorosa
a combination of pain and numbness

anticonvulsant
medication that prevents convulsions or seizures

aplastic anemia
potentially fatal blood disorder caused by damage to bone marrow. Rare but potential side effect of some anticonvulsant medications

arachnoid arachnoiditis
a membrane of the brain. When abnormally thickened, it is a potential cause of compression on the trigeminal nerve and is then termed arachnoiditis.

arteriovenous malformation (AVM)
an abnormal growth of blood vessels that sometimes rupture without warning. These vessels can cause TN if they grow near and compress the trigeminal nerve.

aseptic
not due to an infection

asymptomatic
no symptoms or complaints

ataxia
inability to walk straight

atrophic
wasted, smaller than usual

atypical
irregular, not conforming to the type

atypical trigeminal neuralgia
a type of facial pain that may have some of the characteristics of classic TN (i.e. sharp stabs and trigger points) but also symptoms that are not common to classic TN (i.e. constant, aching or burning pain in addition to the stabs).

atypical_face_pain
facial pain with mixed symptoms and of unknown origin. More recently termed chronic facial pain to reflect its unknown cause

Atypical_Odontalgia
pain in the tooth-bearing area, which is not due to dental causes.

auditory
hearing

avulsion
tearing away of a structure, as in removing or cutting away a section of nerve.

axon
process of a nerve cell by which impulses travel away from the cell body

balloon compression
also called microcompression. Is a technique performed at the level of Gasserian ganglion, which is aimed at pressing the nerve against some bony tissue and, in so doing, damage it enough to stop transmission of painful stimuli.

bilateral
referring to both sides. Bilateral TN means pain on both sides of the face.

biofeedback
a technique in which people learn to control body functions such as breathing rate, blood pressure and body temperature by responding to feedback from electrodes that monitor changing body conditions.

biomedical model of care
a model in which the doctor makes a diagnosis and then treats the condition or disease using medicines or surgery.

biopsychosocial model of care
the doctor makes a diagnosis and then provides treatment based not just on medicines and surgery, but also taking into account the patients’ social circumstances and their psychological approach to the illness.

Botox
a purified form of the botulinum toxin that, when injected, can partially paralyze muscles. Usually used in tightening wrinkled skin , it also is being being tried as a temporary TN pain-relief measure. It is used for treatment of hemifacial spasm.

buccal
inside the cheek

burning mouth syndrome
sensation of burning, especially of the tongue, but can include all of the mouth. Often associated with altered taste, dryness, and is considered a neuropathic pain.

capsaicin
the chemical that makes hot peppers hot. Used in a topical cream, it sometimes is used to treat TN.

case control study
a study of a particular disease or factor in which there is a control group of individuals who do not have the disease or factor being studied.

catheter
a hollow tube used to drain fluids from the body, to introduce liquids to the body, or in the case of TN, to allow passage of a balloon to the site of the trigeminal nerve.

cerebellum
part of the brain that controls movements.

cerebral cortex
part of the brain that analyzes nerve signals and sends out responses.

Cerebrospinal fluid
a fluid composed mostly of water, glucose, salt and proteins that surrounds, cushions and provides nutrients to the brain and spinal cord.

Cervix
the top vertebrae of the spine where the trigeminal nerve originates and through which the spinal cord passes to connect to the brain stem.

Chronic paroxysmal hemicrania
Multiple severe but short headache attacks normally affecting females and normally affecting one side of the cranium

Cistern
space around a structure; in the case of the trigeminal nerve, it is the area around the Gasserian ganglion.

Cisternography
closed space filled with fluid so it can be seen on X-ray films; in the case of trigeminal neuralgia, the Gasserian ganglion.

Cluster headache
searing, boring, come-and-go pain in the face or forehead thought to be caused by dilation of the blood vessels in the skull. Sometimes confused with trigeminal neuralgia.

Cluster tic syndrome
Clinical pain pattern in which symptoms of cluster headache and tic douloureux co-exist

Cognitive behaviour therapy (CBT)
a psychological treatment that helps people examine the way they think and respond to situations. Treatment aims at learning more helpful ways of responding.

Cohort
a group of individuals with a particular disease or factor who are being followed up for a longer period of time. it is prospective if planned in advance and retrospective if the data was collected before the study was planned.

Computer tomography
sophisticated X-ray imaging technology that which produces pictures of layers of the body at any depth.

Conjunctiva
thin lining of the eylelids and the exposed sclera of the eye.

Contrast medium
a liquid solution that can be seen on X-ray films.

Control trial
a standard against which experimental observations may be evaluated. Matched control means that the experimental group only differs from the control group by the one factor that is being studied, e.g. all groups are the same in age, gender.

Controlled prospective studies or cohort studies
studies that have been planned in advance and follow patients for a longer period of time.

Convulsants
see anticonvulsants.

Coping strategies
thoughts and behaviors that are used to manage or cope with stressful situations.

Cornea
transparent part forming the front of the eye.

Corneal reflex
eye closure reflex , protective mechanism to close the eye if it is irritated.

Cranial nerves
twelve pairs of nerves that serve various areas and functions of the head. The trigeminal nerve is one of these nerves, called the fifth.

Craniectomy
surgical opening in the skull necessary for brain surgery. The bone is not replaced after surgery.

Craniotomy
surgical opening in the skull necessary for brain surgery. The bone is replaced after surgery.

Cryotherapy
using cold agents to deaden or kill nerve fibers. Sometimes used to treat TN.

CSF
cerebro spinal fluid this fluid. this serumlike fluid circulates through parts of the the brain, the cavity of the spinal cord, and the subarachnoid space, functioning as a shock absorption.

CT scan
an internal picture of the body constructed by a computer by piecing together a series of X-ray images. Sometimes used in detecting tumors (CT stands for computed tomography).

Deafferentation pain
pain that occurs when parts of a nerve are injured to the point where they’re disabled. It’s usually a constant, burning type of pain.

Deep brain stimulation
an experimental procedure in which surgeons insert a thin electrode through a small opening in the skull into the thalamus, a part of the brain where pain sensation occurs. A stimulation device attached to the electrode delivers low-grade electrical signals in an attempt to override pain signals.

Demyelination
the process of losing or destroying myelin, the protective sheath around nerve fibers.

Diplopia
seeing two images instead of one

DREZ
acronym for "Dorsal Root Entry Zone," a surgical procedure done in the neck region to disable the origin of the trigeminal nerve in the upper spine.

Dura
the waterproof covering that surrounds the brain

Dysesthesia
a numbness or abnormal sensation severe enough that a patient considers it disturbing. An unpleasant sensation, whether spontaneous or evoked.

Edema (Also Oedema)
swelling

Electrode
small pointed tool used to deliver controlled charges of electricity or radiowaves

Endodontist
dentist who specializes in filling root canals of teeth

Endoscope
a new surgical instrument that uses a tiny camera to project brightened and magnified images from inside the body.

Epidemiology
the study of disease as it occurs in groups of people or even other populations.

Epilepsy
disorder of the nervous system marked by seizures and temporary losses of consciousness or concentration.

Etiology
cause.

Facial migraine
A migraine of the face. Features include pulsating, ice-pick-like pain that also occurs in throbbing attacks for hours or even days at a time. It typically affects nostrils, cheeks, gums and teeth, and the pain may be accompanied by nausea. During facial migrain attacks, patients are also often highly sensitive to noise and light. Medications such as indomethacin (Indocin) and sumatriptan (Imitrex) are used to prevent and treat it.

Facial nerve
a cranial nerve that controls most of the muscles in the face. This is a separate nerve from the trigeminal nerve, which controls sensation in the face and some of the muscles that control chewing.

Facial palsy
weakness of the muscles of facial expression.

Fluoroscope
a fluorescent X-ray device that surgeons use to guide a needle or catheter to the right location in the body.

Folic acid
an essential vitamin found in green vegetables and red meat, which can be depleted by some anticonvulsant drugs.

Foramen ovale
the opening in the skull through which the trigeminal nerve passes on its way into the face.

Gamma Knife
a non-incision surgical device that uses Gamma radiation to cause precisely aimed damage to targeted tissue. Used to create lesions on the root of the trigeminal nerve.

Gangliolysis
A surgical procedure to create targeted damage to a ganglion, usually to stop pain signals from getting to the brain.

Ganglion
a cluster of nerve cells.

Gasserian ganglion
the cluster of nerve cells where the trigeminal nerve branches out into its three divisions and exits the skull. Sometimes just called trigeminal ganglion or semilunar ganglion.

Gate control
a theory to explain how pain is experienced.

Geniculate neuralgia (Nervus intermedius neuralgia)
Severe intermittent pain deep in the ear that may spread to the ear canal, outer ear, mastoid or eye region. Very rare and can be confused with glossopharyneal neuralgia.

Glossopharyngeal neuralgia
similar condition to TN, except that this pain is in the throat and neck. Causes are thought to be similar to TN, but involving the glossopharyngeal nerve.

Glycerol
an oily alcohol substance that damages nerve fibers when in direct contact with the fibers.

Hematoma
bruise.

Herpes zoster
also known as shingles, this is a viral infection caused by the same virus that causes chickenpox. When it strikes the face, it can cause burning pain.

Hyperalgesia
an increased response to a stimulus, which is normally painful.

Hypesthesia
medical term for numbness.

Hyponatremia
abnormally low levels of blood sodium. Can be a side effect of some TN medications.

Idiopathic
refers to a disease or condition of unknown cause or origin.

Intraoral
inside the mouth.

Keratatis
inflammation of the cornea transparent front lining of the eye.

Lacrimal
pertaining to tears.

Lesion
an area of tissue damage.

Leukopenia
a deficiency in white blood cells, which protect the body against disease-causing microorganisms. Can be a side effect of some TN medications.

Levetiracetam (Kepra)
anticonvulsant drug used to treat trigeminal neuralgia.

LILT
acronym for Low-Intensity Laser Therapy, in which beams of highly focused laser light are delivered to an area of pain in order to provide pain-relief.

LINAC (linear accelerator)
a non-incision surgical device that uses high-energy X-rays to cause precisely aimed damage to targeted tissues. Often used for tumors, but sometimes for TN.

Lumbar puncture
insertion of a needle into the back to tap out CSF for testing.

Magnetic resonance imaging (MRI)
a device that creates computerized images of the body's interior. Instead of using radiation as in an X-ray, MRI involves a rapid series of pictures taken while the subject is inside a magnetized chamber. An MRI brain scan is painless and is useful in detecting multiple sclerosis and brain tumors.

Magnetic resonance tomographic angiography (MRTA)
a type of imaging similar to MRI that can pick up even very small blood vessels. Gadolinium dye is injected into the patient's bloodstream to enhance the image.

Mandibular
area referring to the lower jaw region of the face.

Mastoid
part of the temporal bone that forms the skull.

Maxillary
area referring to the upper jaw and cheek region of the face.

McGill Pain Questionnaire
a questionnaire to assess pain character and severity.

Mean
average.

Meckel's cave
cavity inside the skull that is made up of dura mater ( brain lining material) in which sits the trigeminal (Gasserian) ganglion and the divisions of the trigeminal nerve.

Median
a statistical term referring to the value above which 50 % of the other values lie and below which 50 % of the values lie, or is the middle value in a series of values.

Meningioma
a tumor of the meninges, the membrane that covers the brain and spinal cord. This can cause TN if the tumor pushes a blood vessel against the trigeminal nerve.

Meningitis
an inflammation of the membrane that covers the brain and spinal cord. It is a potential complication of brain surgery. It can be bacterial, i.e due to an infection, or aseptic due to irritation.

Microcompression
see balloon compression.

Morbidity
a disease/ or side effect.

Motor
muscle, nerve or center that affects or produces movement

MRI
Magnetic resonance imaging (MRI) is primarily used in medical imaging to visualize the structure and function of the body.

MRTA
a type of imaging similar to MRI that can pick up even very small blood vessels. Gadolinium dye is injected into the patient's bloodstream to enhance the image.

MS
a degenerative disease affecting the central nervous system. MS causes scarring of nerve fibers and leads to such symptoms as arm and leg weakness, numbness, double vision and impaired coordination and movement.

Multiple sclerosis (MS)
a degenerative disease affecting the central nervous system. MS causes scarring of nerve fibers and leads to such symptoms as arm and leg weakness, numbness, double vision and impaired coordination and movement.

myelin
the protective coating that surrounds nerve fibers. It's made out of a layer of proteins packed between two layers of lipids (fats).

Myofascial pain
dull, aching constant pain in the jaw that is worse when chewing. It is an affliction of the jaw muscle rather than the nerves, that i often associated with frequent teeth grinding. If intermettent can be confused with TN. (probably the same as temporomandibular disorders)

Nasolabial
area down the side of the nose and the lips.

Natural history of a disease
how the disease would run its course if no treatment was given.

Nerve block
use of a drug, chemical or surgery to stop a nerve signal from getting through to the brain. In the case of TN, these can be used for temporary pain relief or as a way to diagnose the exact nature and location of a pain.

Nerve fiber
a strand of tissue made up of nerve cells that carry nerve impulses (biochemical signals to and from the brain).

Nervus intermedius
a branch of the facial nerve formed in the geniculate ganglion, provides fibers for taste to the front of the tongue and releases secretions for the salivary glands.

Neurectomy
surgical removal of a nerve or nerve branch.

Neuroma
a tangle of poorly developed nerve endings that resprout following a nerve injury.

Neuromodulation
stimulation of sensory nerve branches in order to reduce pain

Neurons
cells that send and receive electrical signals to and from parts of the body. These are the nerve cells that are stimulated to send impulses (messages) to and from the brain.

Neuropathic pain
pain that originates in the nerve, usually due to injury or disease.

Neuropathy
disturbance of function or pathological change in a sensory nerve causing numbness.

Neuroradiologists
medical doctors trained to interpret scans and MRIs; these specialists have a special interest in images related to neurological disease.

Neurovascular
nerve and blood vessel.

Neutropenia
a diminished number of neutrophils, a type of white blood cell needed to fight infections. Can be a side effect of some TN medications.

NICO
acronym for Neuralgia-Inducing Cavitational Osteonecrosis, a controversial type of facial pain that may be confused with TN. Presumed cause is a chronic infection of bone in the jaw that can damage the nerve branches in the affected bone.

Nociceptor
a type of nerve receptor that activate when there's a painful stimulus.

Occipital neuralgia
Chronic pain in the upper neck, back of head and behind the ear

Oedema
swelling.

Ophthalmic
area referring to the region of the face around the eyes.

Opioids
pain-killing agents that originate from the poppy flower and its product opium (Morphine and codeine were two of the earliest opioids).

Orofacial
area of the face around the mouth.

Otitis media
inflammation of the middle ear.

Palsy
paralysis.

Pancytopenia
abnormal decrease in all types of blood cells. Can be a side effect of some TN medications.

Paresthesia
an unusual sensation that may be described as tingling, crawling or pins and needles. Often accompanies mild numbness.An abnormal sensation, whether spontaneous or evoked.

Pathogen
a disease-producing organism.

Percutaneous
through the skin. When referring to percutaneous procedures in treating TN, it means a type of surgery in which the surgeon inserts a needle or electrode through the cheek as opposed to entering the skull.

Peripheral nerves
nerves outside the brain and spinal cord. In the case of TN, these include the many branches of the trigeminal nerve that serve the teeth, gums and other parts of the face.

Pons
part of the brain stem to which the trigeminal nerve is connected; posterior part lying between medulla and midbrain.

Post-herpetic neuralgia
a type of facial pain caused by damage from the herpes zoster (chickenpox) virus. Can occur after a bout of shingles.

Post-traumatic neuralgia
a type of facial pain caused by physical damage to the trigeminal nerve and /or its branches.

Posterior fossa
hollow in the back of the skull where the brain stem lies and area where the trigeminal nerve emerges from the brain.

Posterior- anterior X-ray of the skull
a standard view of the skull.

Preganglionic
situated proximal to the ganglion; in the trigeminal nerve, this refers to before the Gasserian ganglion.

Pretrigeminal neuralgia
a precursor to TN marked by more of a constant ache than sharp, stabbing attacks that are triggered by light touches to the face.

Prevalence
the total number of cases of a disease at a certain time in a particular place.

Prognosis
forecast as to the probable outcome of a disease.

Psychogenic
having a psychological component.

Radiofrequency
the use of generated heat through an electrode to cause selected damage to tissue. One type of surgical treatment for TN.

Radiographer
specialist trained to carry out scans and MRIs (Radiographers are not medical doctors).

Radiosurgery
the use of radiation devices to treat diseases and disorders without having to cut into tissue. Two examples of devices used in treating TN are Gamma Knife and Linac.

Randomized controlled trial (RCT)
refers to a study that aims to reduce bias towards the new treatment being used by keeping both doctors and patients blinded as to which is the new treatment.

Refractory
does not respond.

Remyelination
the process of rebuilding lost or damaged myelin, the protective sheath around nerve fibers.

Rhizotomy
a surgical procedure to cut or damage a nerve root so as to interfere with the transmission of pain signals to the brain.

Root canal
an oral surgical procedure in which the nerve is removed from an inflamed tooth.

Root entry zone
the section of the trigeminal nerve near the brain stem at which point the myelin (covering) changes.

Schwann cell
a type of glial cell that the body uses to build myelin in nerves outside the central nervous system.

Shared Decision Making
presents patients with evidence-based, unbiased views of their health-care options, and encourages patients to work with their doctors to choose the health-care options that are right for them.

Sinusitis
Inflammation of the paranasal sinuses, which may or may not be as a result of infection

Stereotactic
Guided by X-ray imaging or similar scanning devices. A way for TN surgeons to be guided to precise, three-dimensional locations in the skull and face.

SUNA
acronym for 'short-lasting, unilateral, neuralgiform headaches with autonomic symptoms' and may be the same a SUNCT as the other features are the same.

SUNCT
acronym for Short-Lasting, Unilateral, Neuralgiform headaches with Conjunctival injection and Tearing. Sometimes confused with TN, it's a sharp, come-and-go pain centering around the eye, along with a red eye, tearing and a runny nose. Believed to be caused by an inflammation of blood vessels around the eye.

Superior laryngeal neuralgia
A rare disorder characterised by severe pain in the side of the throat, the lower jaw and underneath the ear, triggered by swallowing, shouting or turning the head

Symptomatic trigeminal neuralgia
trigeminal nerve pain that occurs as a result of another condition, such as multiple sclerosis or a tumor.

Synapse
gaps between nerve fibers that nerve impulses must jump to continue on.

Systematic review
as the name implies, this is a rigorous process of finding every single clinical study on the given topic, and then critically appraising this data and only using the high quality studies to make observations in terms of treatment.

Systemic
whole body.

Tarsorrhaphy
an operation for suturing together a part or all of the upper and lower eyelids to protect the cornea.

Temporal arteritis
aching, throbbing and sometimes burning pain in the temple area caused by an inflamed artery in that area. Sometimes confused with TN.

Temporomandibular joint disorder
see TMJ/TMD.

TENS unit
a device that delivers regular, low-grade electrical signals that distract or override pain signals. TENS stands for Transcutaneous Electrical Stimulation.

Thalamus
the part of the brain that relays messages between various parts of the body and the appropriate other part of the brain. It functions as the brain's central switching station.

Thermocoagulation
a procedure using heat to create tissue injury. It's the technique applied in the radiofrequency lesioning surgery used to treat TN.

Thin-cut MRI
see MRI. Words "thin cut" relate to the special technique used to enhance visibility of the trigeminal nerve and vessels.

Thrombocytopenia
abnormally low blood platelets, which are needed for clotting; can be a side effect of some TN medications.

Tic douloureux
another name for trigeminal neuralgia. (means "painful spasm" in French).

Tinnitus
ringing in the ears.

TMJ / TMD
pain in the jaw joint sometimes confused with TN. The jaw joint is the temporomandibular joint.

TMJ or TMD
Pain in the jaw joint sometimes confused with TN. The jaw joint is the temporomandibular joint

Trigeminal Autonomic Cephalgia
refers to a group of facial pains that are all associated with over activity of the trigeminal nerve. Includes conditions such as cluster headaches.

Trigeminal Nerve
The trigeminal nerve (the fifth cranial nerve, also called the fifth nerve or simply V) is responsible for sensation in the face. Sensory information from the face and body is processed by parallel pathways in the central nervous system.

Trigeminal neuritis
an inflammation of the trigeminal nerve and/or its branches.

Trigger point
the site, often at the end of a nerve, which, if touched, results in pain.

Trismus
spasm of the muscles opening the mouth.

Tumor
abnormal growth of tissue; if uncontrolled and progressive, called malignant; if under control, called benign.

Vertigo
illusion of movement and a feeling that the outside world is rotating round, not the same as dizziness.

Visceral
any large internal organ.


Page last updated on 13 Oct 2008