SlideShare una empresa de Scribd logo
1 de 30
TRIGEMINAL NEURALGIA
SMRGU.23 Nov.2013
FACIAL PAIN

Presents along side with headache
PATIENT ASSESMENT WITH
FACIAL PAIN

age
SEX PREVALENCE
High Risk Group

Low Risk group
Cont.
Localisation could be
unilateral

OR

Localisation could be
• Bilateral
OTHERS
Class A
• Quality : throbbing, sharp
• Trigger zone: touch the site
where the originate (nerve
root identificattion )

Class b
• Frequency : can be constant
Or paroxysmal remission.
CAUSES
1.Trigeminal nerve
compression
2.Headache
3.Toothache

4.Sinusitis
5.Injury to the face .
6.Temeperomandibular joint
dysfunction.
TRIGEMINAL NEURALGIA
SUCIDE DISEASE
TYPES
OF PAIN
1.NOCICEPTIVE
2.NON NOCICEPTIVE (NEUROPATHIC PAIN)
Neuropathic pain is divide into
* Trigrminal neuralgia
*Postherpetic neuralgia
THIS IS TRIGEMINAL NEURALGIA !!!!
UNDERLINE CAUSES
TUMORS
TRAUMATIC DAMAGE
SYMPTOMS OF
TRIGEMINAL
NEURALGIA
1.INTERMITTENT TWINGES OF MILD PAIN

2.SEVERE EPISODE OF SEARING,SHOOTING,JABBING PAIN THAT FEELS LIKE ELECTRIC SHO
3.UNILATERAL PAIN.
TINGLING AND NUMBNESS OF THE FACE.
AREAS OF PAIN
CLASSIFICATION OF TRN
TYPICAL TIGEMINAL NEURALGIA

• PAIN IS SHARP,THROBBING,
AND ELECTEIC SHOCK LIKE
..THERE IS NO WEAKNESS OR
FACIAL NUMBESS

ATYPICAL TRIGEMINAL
NEURALGIA

• BURNING PAIN,ACHING
PAIN, CRAMPING PAIN.
• IT EXTEND TO THE REGION
OF THE NECK.
• IT IS HARDER TO DIAGNOSE
PEOPLE WITH ATYPICAL TRN
DIAGNOSIS

MRI
PHARMACOLOGICAL APPROAC
TRIGEMINAL NEURALGIA
ANTI CONVULSANT :
TEGRETOL,CARBATROL. SOMETIMES GABAPENTINE IS USED.

Side effect include: dizziness , confusion , drowsiness ,vision problem
e.t.c
sucidal thoughts.

ANTISPASTICITY AGENTS : BACLOFEN EITHER INDEPENDENTLY OR IN
COMBINATION WITH CARBAMAZEPINE OR PHENYTOIN .

ALCOHOL INJECTION : CAUSES NUMBING EFFECT
SURGICAL APPROACH TO TRIGEMINAL
NEURALGIA
GOALS OF SURGEON DURING SURGERY

1.DECOMPRESSION OR 2 SEVERING OF THE NER
SURGICAL
APPROACH

1.MICROVASCULAR DECOMPRESSION S
2.PERCUTANEOUS GLYCEROL RHIZOTOM
3.PERCUTANEOUS BALLON COMPRESSI
NERVE (PBCTN)
4.PERCUTANEOUS STEREOSTATIC RADI
THERMAL RHIZOTOMY (PSRTR)
5.PARTIAL SENSORY RHIZOTOMY
6.GAMMA KNIFE RADIOSURGERY
MVD
PREVENTION

There are no guildlines for preventin g the
development of trigeminal neuralgia,but
You can only take steps to prevent the attack.
TIPS TO AVIOD ATTACKS

1.EAT LUKEWARM FOODS AND DRINKS
2.EAT SOFT FOOD
3.AVIOD KNOWN TRIGGERS.
4.USE COTTON PADS WHEN WASHING YOUR FACE
WELCOME TO,OUTSIDE
THE BOX THOUGHT
PROCESS

1901
2 CONCLUSIONS

1904
Trigeminal Neuralgia ,
Trigeminal Neuralgia ,

Más contenido relacionado

La actualidad más candente

Temporomandibular joint disorders I
Temporomandibular joint disorders ITemporomandibular joint disorders I
Temporomandibular joint disorders IIAU Dent
 
Orofacial Pain
Orofacial PainOrofacial Pain
Orofacial PainHadi Munib
 
Trigeminal neuralgia - Dr Sanjana Ravindra
Trigeminal neuralgia - Dr Sanjana RavindraTrigeminal neuralgia - Dr Sanjana Ravindra
Trigeminal neuralgia - Dr Sanjana RavindraDr. Sanjana Ravindra
 
Orofacial pain / Dr.Sarah alkhateeb
Orofacial pain / Dr.Sarah alkhateebOrofacial pain / Dr.Sarah alkhateeb
Orofacial pain / Dr.Sarah alkhateebDr.Sarah Al-khateeb
 
Management Of Lingual Nerve injury
Management Of Lingual Nerve injuryManagement Of Lingual Nerve injury
Management Of Lingual Nerve injurymohammed Omer
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgiaakifab93
 
trigeminal neuralgia
trigeminal neuralgiatrigeminal neuralgia
trigeminal neuralgiaGauri243453
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgiaChetan Basnet
 
trigeminal neuralgia and its dental considerations
trigeminal neuralgia and its dental considerationstrigeminal neuralgia and its dental considerations
trigeminal neuralgia and its dental considerationsGulshan Raghani
 

La actualidad más candente (20)

Facial pain
Facial painFacial pain
Facial pain
 
Facial pain
Facial painFacial pain
Facial pain
 
Orofacial pain
Orofacial painOrofacial pain
Orofacial pain
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
Temporomandibular joint disorders I
Temporomandibular joint disorders ITemporomandibular joint disorders I
Temporomandibular joint disorders I
 
Orofacial Pain
Orofacial PainOrofacial Pain
Orofacial Pain
 
trigeminal neuralgia
trigeminal neuralgiatrigeminal neuralgia
trigeminal neuralgia
 
Orofacial pain
Orofacial pain Orofacial pain
Orofacial pain
 
Trigeminal neuralgia - Dr Sanjana Ravindra
Trigeminal neuralgia - Dr Sanjana RavindraTrigeminal neuralgia - Dr Sanjana Ravindra
Trigeminal neuralgia - Dr Sanjana Ravindra
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
Orofacial pain / Dr.Sarah alkhateeb
Orofacial pain / Dr.Sarah alkhateebOrofacial pain / Dr.Sarah alkhateeb
Orofacial pain / Dr.Sarah alkhateeb
 
Orofacial pain
Orofacial painOrofacial pain
Orofacial pain
 
Management Of Lingual Nerve injury
Management Of Lingual Nerve injuryManagement Of Lingual Nerve injury
Management Of Lingual Nerve injury
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
trigeminal neuralgia
trigeminal neuralgiatrigeminal neuralgia
trigeminal neuralgia
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
Dr Samreen Younas
Dr Samreen YounasDr Samreen Younas
Dr Samreen Younas
 
trigeminal neuralgia and its dental considerations
trigeminal neuralgia and its dental considerationstrigeminal neuralgia and its dental considerations
trigeminal neuralgia and its dental considerations
 

Destacado

Differentiating trigeminal neuropathy from trigeminal neuralgia
Differentiating trigeminal neuropathy from trigeminal neuralgiaDifferentiating trigeminal neuropathy from trigeminal neuralgia
Differentiating trigeminal neuropathy from trigeminal neuralgiaDr P Deepak
 
Trigeminal Nerve Anatomy
Trigeminal Nerve AnatomyTrigeminal Nerve Anatomy
Trigeminal Nerve Anatomydrharshpatel21
 
Trigeminal neuralgia presentation
Trigeminal neuralgia presentationTrigeminal neuralgia presentation
Trigeminal neuralgia presentationdr anuradha
 
Trigeminal Neuralgia
Trigeminal NeuralgiaTrigeminal Neuralgia
Trigeminal Neuralgiashabeel pn
 

Destacado (7)

Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
Differentiating trigeminal neuropathy from trigeminal neuralgia
Differentiating trigeminal neuropathy from trigeminal neuralgiaDifferentiating trigeminal neuropathy from trigeminal neuralgia
Differentiating trigeminal neuropathy from trigeminal neuralgia
 
Trigeminal neuralgia 2_
Trigeminal neuralgia 2_Trigeminal neuralgia 2_
Trigeminal neuralgia 2_
 
Trigeminal nerve
Trigeminal nerveTrigeminal nerve
Trigeminal nerve
 
Trigeminal Nerve Anatomy
Trigeminal Nerve AnatomyTrigeminal Nerve Anatomy
Trigeminal Nerve Anatomy
 
Trigeminal neuralgia presentation
Trigeminal neuralgia presentationTrigeminal neuralgia presentation
Trigeminal neuralgia presentation
 
Trigeminal Neuralgia
Trigeminal NeuralgiaTrigeminal Neuralgia
Trigeminal Neuralgia
 

Similar a Trigeminal Neuralgia ,

Similar a Trigeminal Neuralgia , (20)

Trigeminal_neuralgia_.pptx
Trigeminal_neuralgia_.pptxTrigeminal_neuralgia_.pptx
Trigeminal_neuralgia_.pptx
 
Diseases of Nerves
Diseases of NervesDiseases of Nerves
Diseases of Nerves
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
Trigeminal Neuralgia
Trigeminal NeuralgiaTrigeminal Neuralgia
Trigeminal Neuralgia
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
trigeminal-neuralgia.pptxjkkkklllooollo876
trigeminal-neuralgia.pptxjkkkklllooollo876trigeminal-neuralgia.pptxjkkkklllooollo876
trigeminal-neuralgia.pptxjkkkklllooollo876
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
Presentation on Trigeminal Neuralgia
Presentation on Trigeminal NeuralgiaPresentation on Trigeminal Neuralgia
Presentation on Trigeminal Neuralgia
 
TRIGEMINAL_NEURALGIA.pptx
TRIGEMINAL_NEURALGIA.pptxTRIGEMINAL_NEURALGIA.pptx
TRIGEMINAL_NEURALGIA.pptx
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
Orofacial pain power point 2021.pptx
Orofacial pain power point 2021.pptxOrofacial pain power point 2021.pptx
Orofacial pain power point 2021.pptx
 
25 introduction and types of neuralgias
25 introduction and types of neuralgias25 introduction and types of neuralgias
25 introduction and types of neuralgias
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
Symptomatology and pathophysiology of trigeminal neuralgia copy
Symptomatology and pathophysiology of trigeminal neuralgia   copySymptomatology and pathophysiology of trigeminal neuralgia   copy
Symptomatology and pathophysiology of trigeminal neuralgia copy
 
Trigeminal neuralgia
Trigeminal neuralgiaTrigeminal neuralgia
Trigeminal neuralgia
 
Pain
PainPain
Pain
 
Trigeminal Neuralgia
Trigeminal NeuralgiaTrigeminal Neuralgia
Trigeminal Neuralgia
 
Prosopalgia
ProsopalgiaProsopalgia
Prosopalgia
 
trigeminal neuralgia.pptx
trigeminal  neuralgia.pptxtrigeminal  neuralgia.pptx
trigeminal neuralgia.pptx
 
Trigeminalneuralgiaseminar2 180526065218-converted
Trigeminalneuralgiaseminar2 180526065218-convertedTrigeminalneuralgiaseminar2 180526065218-converted
Trigeminalneuralgiaseminar2 180526065218-converted
 

Más de Ruben Gombalandi

opporturnistic infection in HIV patients,management and prevention
opporturnistic infection in HIV patients,management and preventionopporturnistic infection in HIV patients,management and prevention
opporturnistic infection in HIV patients,management and preventionRuben Gombalandi
 
The genetics of pain by Edmund Aja Bisong, Vinnitsa 2015
The genetics of pain by Edmund Aja Bisong, Vinnitsa 2015The genetics of pain by Edmund Aja Bisong, Vinnitsa 2015
The genetics of pain by Edmund Aja Bisong, Vinnitsa 2015Ruben Gombalandi
 
Lecture 1 hemostasis first secion
Lecture 1 hemostasis first secionLecture 1 hemostasis first secion
Lecture 1 hemostasis first secionRuben Gombalandi
 
Studies on cycloferon by VICTORIA, RUBEN GOMBALANDI, IMMUNOMODULATORS
Studies on cycloferon by VICTORIA, RUBEN GOMBALANDI, IMMUNOMODULATORSStudies on cycloferon by VICTORIA, RUBEN GOMBALANDI, IMMUNOMODULATORS
Studies on cycloferon by VICTORIA, RUBEN GOMBALANDI, IMMUNOMODULATORSRuben Gombalandi
 

Más de Ruben Gombalandi (14)

Peptic ulcer
Peptic ulcerPeptic ulcer
Peptic ulcer
 
opporturnistic infection in HIV patients,management and prevention
opporturnistic infection in HIV patients,management and preventionopporturnistic infection in HIV patients,management and prevention
opporturnistic infection in HIV patients,management and prevention
 
acute pregnancy leukemia
acute pregnancy leukemiaacute pregnancy leukemia
acute pregnancy leukemia
 
The genetics of pain by Edmund Aja Bisong, Vinnitsa 2015
The genetics of pain by Edmund Aja Bisong, Vinnitsa 2015The genetics of pain by Edmund Aja Bisong, Vinnitsa 2015
The genetics of pain by Edmund Aja Bisong, Vinnitsa 2015
 
Think outside the box
Think outside the boxThink outside the box
Think outside the box
 
Lecture 1 hemostasis first secion
Lecture 1 hemostasis first secionLecture 1 hemostasis first secion
Lecture 1 hemostasis first secion
 
Studies on cycloferon by VICTORIA, RUBEN GOMBALANDI, IMMUNOMODULATORS
Studies on cycloferon by VICTORIA, RUBEN GOMBALANDI, IMMUNOMODULATORSStudies on cycloferon by VICTORIA, RUBEN GOMBALANDI, IMMUNOMODULATORS
Studies on cycloferon by VICTORIA, RUBEN GOMBALANDI, IMMUNOMODULATORS
 
Sids ruben
Sids rubenSids ruben
Sids ruben
 
Sids ruben copy
Sids ruben   copySids ruben   copy
Sids ruben copy
 
Rickets
RicketsRickets
Rickets
 
Sids ruben
Sids rubenSids ruben
Sids ruben
 
Pepticulcer
Pepticulcer Pepticulcer
Pepticulcer
 
Alzheimer disease (ad)
Alzheimer disease (ad)Alzheimer disease (ad)
Alzheimer disease (ad)
 
Greatness
GreatnessGreatness
Greatness
 

Último

Activity 01 - Artificial Culture (1).pdf
Activity 01 - Artificial Culture (1).pdfActivity 01 - Artificial Culture (1).pdf
Activity 01 - Artificial Culture (1).pdfciinovamais
 
BAG TECHNIQUE Bag technique-a tool making use of public health bag through wh...
BAG TECHNIQUE Bag technique-a tool making use of public health bag through wh...BAG TECHNIQUE Bag technique-a tool making use of public health bag through wh...
BAG TECHNIQUE Bag technique-a tool making use of public health bag through wh...Sapna Thakur
 
IGNOU MSCCFT and PGDCFT Exam Question Pattern: MCFT003 Counselling and Family...
IGNOU MSCCFT and PGDCFT Exam Question Pattern: MCFT003 Counselling and Family...IGNOU MSCCFT and PGDCFT Exam Question Pattern: MCFT003 Counselling and Family...
IGNOU MSCCFT and PGDCFT Exam Question Pattern: MCFT003 Counselling and Family...PsychoTech Services
 
Kisan Call Centre - To harness potential of ICT in Agriculture by answer farm...
Kisan Call Centre - To harness potential of ICT in Agriculture by answer farm...Kisan Call Centre - To harness potential of ICT in Agriculture by answer farm...
Kisan Call Centre - To harness potential of ICT in Agriculture by answer farm...Krashi Coaching
 
APM Welcome, APM North West Network Conference, Synergies Across Sectors
APM Welcome, APM North West Network Conference, Synergies Across SectorsAPM Welcome, APM North West Network Conference, Synergies Across Sectors
APM Welcome, APM North West Network Conference, Synergies Across SectorsAssociation for Project Management
 
Software Engineering Methodologies (overview)
Software Engineering Methodologies (overview)Software Engineering Methodologies (overview)
Software Engineering Methodologies (overview)eniolaolutunde
 
Unit-IV- Pharma. Marketing Channels.pptx
Unit-IV- Pharma. Marketing Channels.pptxUnit-IV- Pharma. Marketing Channels.pptx
Unit-IV- Pharma. Marketing Channels.pptxVishalSingh1417
 
General AI for Medical Educators April 2024
General AI for Medical Educators April 2024General AI for Medical Educators April 2024
General AI for Medical Educators April 2024Janet Corral
 
Paris 2024 Olympic Geographies - an activity
Paris 2024 Olympic Geographies - an activityParis 2024 Olympic Geographies - an activity
Paris 2024 Olympic Geographies - an activityGeoBlogs
 
Q4-W6-Restating Informational Text Grade 3
Q4-W6-Restating Informational Text Grade 3Q4-W6-Restating Informational Text Grade 3
Q4-W6-Restating Informational Text Grade 3JemimahLaneBuaron
 
Class 11th Physics NEET formula sheet pdf
Class 11th Physics NEET formula sheet pdfClass 11th Physics NEET formula sheet pdf
Class 11th Physics NEET formula sheet pdfAyushMahapatra5
 
social pharmacy d-pharm 1st year by Pragati K. Mahajan
social pharmacy d-pharm 1st year by Pragati K. Mahajansocial pharmacy d-pharm 1st year by Pragati K. Mahajan
social pharmacy d-pharm 1st year by Pragati K. Mahajanpragatimahajan3
 
The Most Excellent Way | 1 Corinthians 13
The Most Excellent Way | 1 Corinthians 13The Most Excellent Way | 1 Corinthians 13
The Most Excellent Way | 1 Corinthians 13Steve Thomason
 
Key note speaker Neum_Admir Softic_ENG.pdf
Key note speaker Neum_Admir Softic_ENG.pdfKey note speaker Neum_Admir Softic_ENG.pdf
Key note speaker Neum_Admir Softic_ENG.pdfAdmir Softic
 
Measures of Central Tendency: Mean, Median and Mode
Measures of Central Tendency: Mean, Median and ModeMeasures of Central Tendency: Mean, Median and Mode
Measures of Central Tendency: Mean, Median and ModeThiyagu K
 
1029-Danh muc Sach Giao Khoa khoi 6.pdf
1029-Danh muc Sach Giao Khoa khoi  6.pdf1029-Danh muc Sach Giao Khoa khoi  6.pdf
1029-Danh muc Sach Giao Khoa khoi 6.pdfQucHHunhnh
 
9548086042 for call girls in Indira Nagar with room service
9548086042  for call girls in Indira Nagar  with room service9548086042  for call girls in Indira Nagar  with room service
9548086042 for call girls in Indira Nagar with room servicediscovermytutordmt
 

Último (20)

Mattingly "AI & Prompt Design: The Basics of Prompt Design"
Mattingly "AI & Prompt Design: The Basics of Prompt Design"Mattingly "AI & Prompt Design: The Basics of Prompt Design"
Mattingly "AI & Prompt Design: The Basics of Prompt Design"
 
Activity 01 - Artificial Culture (1).pdf
Activity 01 - Artificial Culture (1).pdfActivity 01 - Artificial Culture (1).pdf
Activity 01 - Artificial Culture (1).pdf
 
BAG TECHNIQUE Bag technique-a tool making use of public health bag through wh...
BAG TECHNIQUE Bag technique-a tool making use of public health bag through wh...BAG TECHNIQUE Bag technique-a tool making use of public health bag through wh...
BAG TECHNIQUE Bag technique-a tool making use of public health bag through wh...
 
IGNOU MSCCFT and PGDCFT Exam Question Pattern: MCFT003 Counselling and Family...
IGNOU MSCCFT and PGDCFT Exam Question Pattern: MCFT003 Counselling and Family...IGNOU MSCCFT and PGDCFT Exam Question Pattern: MCFT003 Counselling and Family...
IGNOU MSCCFT and PGDCFT Exam Question Pattern: MCFT003 Counselling and Family...
 
Kisan Call Centre - To harness potential of ICT in Agriculture by answer farm...
Kisan Call Centre - To harness potential of ICT in Agriculture by answer farm...Kisan Call Centre - To harness potential of ICT in Agriculture by answer farm...
Kisan Call Centre - To harness potential of ICT in Agriculture by answer farm...
 
APM Welcome, APM North West Network Conference, Synergies Across Sectors
APM Welcome, APM North West Network Conference, Synergies Across SectorsAPM Welcome, APM North West Network Conference, Synergies Across Sectors
APM Welcome, APM North West Network Conference, Synergies Across Sectors
 
Software Engineering Methodologies (overview)
Software Engineering Methodologies (overview)Software Engineering Methodologies (overview)
Software Engineering Methodologies (overview)
 
Unit-IV- Pharma. Marketing Channels.pptx
Unit-IV- Pharma. Marketing Channels.pptxUnit-IV- Pharma. Marketing Channels.pptx
Unit-IV- Pharma. Marketing Channels.pptx
 
General AI for Medical Educators April 2024
General AI for Medical Educators April 2024General AI for Medical Educators April 2024
General AI for Medical Educators April 2024
 
Paris 2024 Olympic Geographies - an activity
Paris 2024 Olympic Geographies - an activityParis 2024 Olympic Geographies - an activity
Paris 2024 Olympic Geographies - an activity
 
Q4-W6-Restating Informational Text Grade 3
Q4-W6-Restating Informational Text Grade 3Q4-W6-Restating Informational Text Grade 3
Q4-W6-Restating Informational Text Grade 3
 
Class 11th Physics NEET formula sheet pdf
Class 11th Physics NEET formula sheet pdfClass 11th Physics NEET formula sheet pdf
Class 11th Physics NEET formula sheet pdf
 
social pharmacy d-pharm 1st year by Pragati K. Mahajan
social pharmacy d-pharm 1st year by Pragati K. Mahajansocial pharmacy d-pharm 1st year by Pragati K. Mahajan
social pharmacy d-pharm 1st year by Pragati K. Mahajan
 
The Most Excellent Way | 1 Corinthians 13
The Most Excellent Way | 1 Corinthians 13The Most Excellent Way | 1 Corinthians 13
The Most Excellent Way | 1 Corinthians 13
 
Key note speaker Neum_Admir Softic_ENG.pdf
Key note speaker Neum_Admir Softic_ENG.pdfKey note speaker Neum_Admir Softic_ENG.pdf
Key note speaker Neum_Admir Softic_ENG.pdf
 
Measures of Central Tendency: Mean, Median and Mode
Measures of Central Tendency: Mean, Median and ModeMeasures of Central Tendency: Mean, Median and Mode
Measures of Central Tendency: Mean, Median and Mode
 
Mattingly "AI & Prompt Design: Structured Data, Assistants, & RAG"
Mattingly "AI & Prompt Design: Structured Data, Assistants, & RAG"Mattingly "AI & Prompt Design: Structured Data, Assistants, & RAG"
Mattingly "AI & Prompt Design: Structured Data, Assistants, & RAG"
 
1029-Danh muc Sach Giao Khoa khoi 6.pdf
1029-Danh muc Sach Giao Khoa khoi  6.pdf1029-Danh muc Sach Giao Khoa khoi  6.pdf
1029-Danh muc Sach Giao Khoa khoi 6.pdf
 
Código Creativo y Arte de Software | Unidad 1
Código Creativo y Arte de Software | Unidad 1Código Creativo y Arte de Software | Unidad 1
Código Creativo y Arte de Software | Unidad 1
 
9548086042 for call girls in Indira Nagar with room service
9548086042  for call girls in Indira Nagar  with room service9548086042  for call girls in Indira Nagar  with room service
9548086042 for call girls in Indira Nagar with room service
 

Trigeminal Neuralgia ,