Neuro clinics 26 - trigeminal nerve

Neuro-clinics 26Trigeminal nerve

Dr Pratyush Chaudhuri

Supported by Mankind Pharmaceuticals and Nirmal clinics

• Mixed Nerve• Largest cranial nerve

Motor functions• Supplies the Massater, temporalis and the internal

and external pterygoids.

• Also supplies the mylohyoid and the ant belly of the digastric ms.

• Tensor veli palatini and tensor vili tympani

• Sensory distribution1. Pontine nucleus2. Mesencephalic nucleus ( proprioceptive sensation from the

muscles supplied by the Vth nerve)

3. Nucleus of descending root (extends upto the c3 – c4 root-

tract of lissauers’

• Sensory supply is also to the 1. Cornea , iris2. Conjuctiva3. Mucosa of the frontal sinus4. Upper part of the nasal cavity.

• Several ganglions are related to the Vth nerve

1. Gasserian ganglion2. Spheno-palatine ganglion3. Otic 4. Submaxillary ganglion

Key Principles of examinations

• Jaw is deflected to the side of the involved nerve and the patient is unable to deviate it towards the unaffected side.

1. Open Jaw – pterygoides2. Close jaw -masseters

• Remember angle of the face is not supplied by the trigeminal – it is supplied by the C2- C3 root

Reflexes1. Corneal reflexes ( direct and consensual)2. Jaw jerk ( masseter reflex)3. Head retraction reflex4. Sneeze reflex5. Reflex of Bechterew

• Pain of trigeminal origin1. Trigeminal neuralgia 2. Herpes ophthalmicus3. Sluders’ syndrome [ neuralgia of spheno-palatine

ganglion]