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Tropical Dental Journal - 1st Pan African international dental journal


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Published in French in Tropical Dental Journal Volume 32 - June 2009 pages 5-12

Clinical and therapeutic aspects of the trigeminal neuralgia: about 27 cases treated at the general hospital of Grand-Yoff in DakarClinical and therapeutic aspects of the trigeminal neuralgia: about 27 cases treated at the general hospital of Grand-Yoff in Dakar est évalué 1 étoiles par les abonnés Tropical Dental Journal Online

Article Open access

Authors : Dia Tine S., Tamba B., Gassama B.B, Niang P., Dia L., Kébé Ndèye F., Badiane S., Diallo B. - Senegal


Résumé

La névralgie faciale essentielle (NFE) du trijumeau (V) ou «tic douloureux» de la face est une affection invalidante, qui affecte la qualité de vie du patient. L’odontologiste doit être capable de la diagnostiquer et de participer à sa bonne prise en charge thérapeutique. Le diagnostic est parfois difficile, pouvant entraîner des modalités thérapeutiques inadaptées préjudiciables pour le patient. L’objectif de notre étude était d’analyser les aspects cliniques et thérapeutiques de la NFE du V. Il s’agit d’une étude transversale descriptive qui a colligé 27 dossiers de patients souffrant de NFE du V et suivis dans le service d’odontologie de l’Hôpital Général de Grand-Yoff (HOGGY) à Dakar entre juillet 2002 et juillet 2008. Nous avons exploité les paramètres suivants : l’âge, le sexe, l’état bucco-dentaire, la durée des symptômes, les caractéristiques de la douleur, le type de traitement. La moyenne d’âge était de 53 ans, avec des extrêmes à 22 et 73 ans et un écart-type de 12,9. Sur les 27 cas, 22 patients étaient de sexe féminin. Le délai de consultation a été souvent tardif, les patients préférant le plus souvent débuter par les traitements traditionnels. La névralgie du V2 a dominé le tableau clinique, suivi de celle du V3. La douleur qui était strictement unilatérale, déclenchée par le moindre mouvement, la parole, l’alimentation ou l’affleurement de la zone gâchette.
La prescription de la carbamazépine (Tégrétol®) a été systématique, et a constituée un véritable test diagnostic, elle a permis d’obtenir une sédation immédiate des douleurs.
Devant l’échec du traitement médicamenteux, l’alcoolisation de la branche trigéminale a donné de bons résultats, en effet elle a permis d’obtenir, une nette accalmie de plus de 12 mois chez 09 patients sur les 10 qui en ont bénéficié.
L’alcoolisation du trijumeau reste un traitement efficace et constitue une alternative accessible dans nos conditions de travail en Afrique.

Abstract
Clinical and therapeutic aspects of the trigeminal neuralgia: about 27 cases treated at the general hospital of Grand-Yoff in Dakar

The trigeminal neuralgia or "painful tic" of the face is an invalidating affection, which affects the quality of life of the patient. The odontologist must be able to diagnose it and take part in his good therapeutic assumption of responsibility. The diagnosis is sometimes difficult, being able to involve unsuited therapeutic methods prejudicial for the patient.
The objective of our study was to analyse the clinical and therapeutic aspects of the trigeminal neuralgia. It was a transverse and descriptive study which 27 files of patients suffering of trigeminal neuralgia and treated in the odontology service of the General hospital of Grand-Yoff in Dakar between July 2002 and July 2008.
We exploited the following parameters: the age, the sex, the oral state, duration of the symptoms, characteristics of the pain, the type of treatment. 22 patients of the 27 cases were female. The time of consultation was often late, the patients generally preferring begin with the traditional treatments. The neuralgia of V2 dominated the clinical picture, followed that neuralgia of V3. The pain was strictly unilateral, it was started by movement, speaking, eating or touching the trigger zone. The prescription of carbamazepine (Tegretol®) was systematic, and constituted a true test diagnosis, it made possible to obtain an immediate sedation of the pains. In front of the medicamentous treatment failure, the alcoholization of the trigeminal branch has given good performances, indeed it made possible to obtain, a clear lull of more than 12 months for 9 patients out of the 10 who profited from it. The alcoholization of the trigeminal nerve remains an effective cure and constitutes an accessible alternative under our work conditions in Africa.

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