scholarly journals Trigeminal neuropathy: Two case reports of gasserian ganglion stimulation

2021 ◽  
Author(s):  
Yannick Logghe ◽  
Iris Smet ◽  
Ali Jerjir ◽  
Peter Verelst ◽  
Marieke Devos ◽  
...  
2017 ◽  
Vol 45 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Lise Kustermans ◽  
Jean-Pierre Van Buyten ◽  
Iris Smet ◽  
Wim Coucke ◽  
Constantinus Politis

1994 ◽  
Vol 81 (5) ◽  
pp. 780-783 ◽  
Author(s):  
Terence J. O'Brien ◽  
Penelope A. McKelvie ◽  
Nikitas Vrodos

✓ Isolated amyloidomas may, albeit rarely, involve the central nervous system. There are three previous reports of amyloidomas that involved the gasserian ganglion and caused unilateral trigeminal neuropathies. The authors report the case of a 49-year-old woman with apparently isolated amyloidomas that caused slowly progressive bilateral trigeminal neuropathies. Magnetic resonance imaging of the brain revealed mild swelling of the left trigeminal nerve within the cavernous sinus and uniform enhancement with gadolinium throughout the length of the nerve. At craniotomy, the trigeminal nerve and ganglion were observed to be infiltrated by a tumor-like mass. Biopsy showed extensive infiltration of the nerve and ganglion by amyloid. Immunocytochemical studies of the amyloid were negative for immunoglobulins, κ and λ light chains, β-amyloid A4 protein, transthyretin, β2-microglobulin, cystatin C, and gelsolin, but weak focal immunoreactivity with antiamyloid AA antibody was seen in the amyloid in vessels and in some intraneural deposits. Extensive investigations failed to reveal evidence of either systemic amyloidoses or an underlying inflammatory disorder or malignancy.


2020 ◽  
pp. 33-38
Author(s):  
Shafik Boyaji

Background: Treatment of trigeminal neuralgia (TN) can be challenging for many physicians; patients who do not respond to conventional treatments and traditional surgical approaches often continue to suffer with pain. The peripheral nerve stimulator has been used to treat many chronic pain conditions, but few reports exist about its use to treat refractory TN through the stimulation of the Gasserian ganglion (GG). Case Report: We present 2 cases of patients with refractory TN who failed conventional medical and surgical management. Both patients were suitable candidates for a trial of peripheral nerve stimulation of the GG, both patients had positive results with the trials, and proceeded with permanent placement of the GG stimulator. In both cases we used deep brain stimulator leads, which were placed under fluoroscopy guidance through the foramen ovale onto the GG, and tunneled through the postauricular area to a pocket in the upper chest wall under the clavicle for the implantable pulse generator. Both of our patients experienced a significant symptomatic and functional improvement in their symptoms. The second patient was successfully weaned off her opioid pain medications after 6 months of treatment. Conclusion: Percutaneous stimulation of the GG is a promising technique for the treatment of refractory trigeminal neuropathic pain. More studies and experiences with this technique are needed to better demonstrate the efficacy and the safety profile, which potentially could allow this procedure to be considered ahead of the more invasive neurodestructive surgical treatments. Key words: Trigeminal neuralgia, Gasserian ganglion, peripheral nerve stimulator


Neurosurgery ◽  
1986 ◽  
Vol 18 (1) ◽  
pp. 59-66 ◽  
Author(s):  
B. A. Meyerson ◽  
S. Håkanson

Abstract Lesions of the peripheral part of the trigeminal nerve may cause trigeminal neuropathy associated with severe pain. Such pain usually does not respond to carbamazepine and analgesics, and it is continuous and lacks the characteristic paroxysmal character of tic douloureux. These patients often present with complex changes of facial sensibility in the form of dysesthesia, hyperalgesia, and allodynia. The pain sometimes responds favorably to transcutaneous nerve stimulation, but direct stimulation of the trigeminal ganglion and rootlets via an implanted electrode provides a greater likelihood of pain relief. Fourteen patients diagnosed as having painful trigeminal neuropathy received implants of a gasserian ganglion-stimulating electrode. The mean follow-up period is 4 years (range, 1 to 7 years). Eleven of the patients have retained the pain-relieving effect, and 1 had pain disappear without further stimulation. Eight of the patients estimated their pain relief to be complete or very good. There were no serious complications, but in several of the patients the electrode had to be exchanged because the insulation of the lead wires broke. For the selection of patients for permanent electrode implantation, a method has been developed for trial stimulation via a percutaneous electrode introduced into the trigeminal cistern. Temporary trial stimulation can be performed for several days. It is concluded that stimulation of the trigeminal ganglion and rootlets with the aid of an implanted electrode may effectively relieve certain forms of trigeminal pain that are otherwise extremely difficult to manage.


2015 ◽  
Vol 9 (1) ◽  
pp. 337-339 ◽  
Author(s):  
Rajat Goel ◽  
Sanjeev Kumar ◽  
Ajay Panwar ◽  
Abhishek B Singh

Orofacial pain’ most commonly occurs due to dental causes like caries, gingivitis or periodontitis. Other common causes of ‘orofacial pain’ are sinusitis, temporomandibular joint(TMJ) dysfunction, otitis externa, tension headache and migraine. In some patients, the etiology of ‘orofacial pain’ remains undetected despite optimal evaluation. A few patients in the practice of clinical dentistry presents with dental pain without any identifiable dental etiology. Such patients are classified under the category of ‘atypical odontalgia’. ‘Atypical odontalgia’ is reported to be prevalent in 2.1% of the individuals. ‘Atypical orofacial pain’ and ‘atypical odontalgia’ can result from the neurological diseases like multiple sclerosis, trigeminal neuralgia and herpes infection. Trigeminal neuralgia has been frequently documented as a cause of ‘atypical orofacial pain’ and ‘atypical odontalgia’. There are a few isolated case reports of acute pontine stroke resulting in ‘atypical orofacial pain’ and ‘atypical odontalgia’. However, pontine stroke as a cause of atypical odontalgia is limited to only a few cases, hence prevalence is not established. This case is one, where a patient presented with acute onset atypical dental pain with no identifiable dental etiology, further diagnosed as an acute pontine infarct on neuroimaging. A 40 years old male presented with acute onset, diffuse teeth pain on right side. Dental examination was normal. Magnetic resonance imaging(MRI) of the brain had an acute infarct in right pons near the trigeminal root entry zone(REZ). Pontine infarct presenting with dental pain as a manifestation of trigeminal neuropathy, has rarely been reported previously. This stresses on the importance of neuroradiology in evaluation of atypical cases of dental pain.


2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Michele Colaci ◽  
Giulia Cassone ◽  
Andreina Manfredi ◽  
Marco Sebastiani ◽  
Dilia Giuggioli ◽  
...  

Objectives. Sjögren’s syndrome (SS) may be complicated by some neurological manifestations, generally sensory polyneuropathy. Furthermore, involvement of cranial nerves was described as rare complications of SS.Methods. We reported 2 cases: the first one was a 40-year-old woman who developed neuritis of the left optic nerve as presenting symptom few years before the diagnosis of SS; the second was a 54-year-old woman who presented a paralysis of the right phrenic nerve 7 years after the SS onset. An exhaustive review of the literature on patients with cranial or phrenic nerve involvements was also carried out.Results. To the best of our knowledge, our second case represents the first observation of SS-associated phrenic nerve mononeuritis, while optic neuritis represents the most frequent cranial nerve involvement detectable in this connective tissue disease. Trigeminal neuropathy is also frequently reported, whereas neuritis involving the other cranial nerves is quite rare.Conclusions. Cranial nerve injury is a harmful complication of SS, even if less commonly recorded compared to peripheral neuropathy. Neurological manifestations may precede the clinical onset of SS; therefore, in patients with apparently isolated cranial nerve involvement, a correct diagnosis of the underlying SS is often delayed or overlooked entirely; in these instances, standard clinicoserological assessment is recommendable.


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