scholarly journals (390) Dexamethasone versus triamcinolone side effects for ultrasound-guided trigeminal nerve block for the treatment of refractory typical or atypical facial pain

2016 ◽  
Vol 17 (4) ◽  
pp. S72 ◽  
Author(s):  
A. Nader ◽  
M. Kendall
Keyword(s):  
Side Effects ◽  
Nerve Block ◽  
Trigeminal Nerve ◽  
Facial Pain ◽  
Atypical Facial Pain ◽  
Ultrasound Guided

scholarly journals Ultrasound-Guided Trigeminal Nerve Block via the Pterygopalatine Fossa: An Effective Treatment for Trigeminal Neuralgia and Atypical Facial Pain

2013 ◽  
Vol 5;16 (5;9) ◽  
pp. E537-E545
Author(s):  
Mark C. Kendall
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Nerve Block ◽  
Trigeminal Nerve ◽  
Local Anesthetic ◽  
Facial Pain ◽  
Case Series ◽  
Pterygopalatine Fossa ◽  
Atypical Facial Pain ◽  
Ultrasound Guided

Background: Patients presenting with facial pain often have ineffective pain relief with medical therapy. Cases refractory to medical management are frequently treated with surgical or minimally invasive procedures with variable success rates. We report on the use of ultrasound-guided trigeminal nerve block via the pterygopalatine fossa in patients following refractory medical and surgical treatment. Objective: To present the immediate and long-term efficacy of ultrasound-guided injections of local anesthetic and steroids in the pterygopalatine fossa in patients with unilateral facial pain that failed pharmacological and surgical interventions. Setting: Academic pain management center. Design: Prospective case series. Methods: Fifteen patients were treated with ultrasound-guided trigeminal nerve block with local anesthetic and steroids placed into the pterygopalatine fossa. Results: All patients achieved complete sensory analgesia to pin prick in the distribution of the V2 branch of the trigeminal nerve and 80% (12 out of 15) achieved complete sensory analgesia in V1, V2, V3 distribution within 15 minutes of the injection. All patients reported pain relief within 5 minutes of the injection. The majority of patients maintained pain relief throughout the 15 month study period. No patients experienced symptoms of local anesthetic toxicity or onset of new neurological sequelae. Limitations: Prospective case series. Conclusion: We conclude that the use of ultrasound guidance for injectate delivery in the pterygopalatine fossa is a simple, free of radiation or magnetization, safe, and effective percutaneous procedure that provides sustained pain relief in trigeminal neuralgia or atypical facial pain patients who have failed previous medical interventions. Key words: Trigeminal nerve, ultrasound-guided, atypical facial pain, trigeminal neuralgia, tic douloureux.

scholarly journals Interventional Management of Refractory Trigeminal Neuropathic Pain: A Prospective Audit of a Novel Management Pathway in 70 Patients

2020 ◽  
Vol 5;23 (9;5) ◽  
pp. E525-E533
Author(s):  
G. Niraj
Keyword(s):  
Neuropathic Pain ◽  
Nerve Block ◽  
Trigeminal Nerve ◽  
Facial Pain ◽  
Standard Treatment ◽  
The Novel ◽  
Prospective Audit ◽  
Ultrasound Guided ◽  
Trigeminal Neuropathic Pain ◽  
Novel Strategy

Background: Trigeminal neuropathic pain (TNP) can present as a constant, unremitting unilateral facial pain. Current management is based on expert recommendation that includes pharmacologic agents and psychological therapy. However, treatment success with pharmacologic management is poor. We adopted a novel strategy that proved to be effective in providing durable relief. Objectives: Prospectively audit a novel strategy in the management of refractory TNP. Study Design: The authors present a prospective audit of a novel structured management pathway in the treatment of refractory TNP. Setting: Multidisciplinary facial pain clinic at a University Teaching Hospital. Methods: Over a 4-year period, 70 patients with unilateral TNP were prospectively audited at a tertiary care university hospital. Initial treatment was based on pharmacologic therapy while the patient awaited psychological therapy. Patients who failed to respond were offered a novel set of interventions that included ultrasound-guided trigeminal nerve block with depot steroids. Results: Patient satisfaction with the novel pathway was high. Only 13 patients (13/70, 18%) responded to standard treatment. Of the 57 patients who were offered the novel intervention, 50 patients consented to undergo the intervention. Forty-two patients (42/50, 84%) reported clinically significant pain relief at 3 months, and 27 patients (27/50, 54%) reported on-going durable relief at 6 months. Treatment failure with the novel intervention was 16%. Out of 54 patients in the employable age, 45 patients (45/54, 83%) were able to maintain gainful employment. Limitations: Open-label, nonrandomized observational design. Conclusions: Standard treatment of TNP is ineffective. The novel set of interventions based on empirical evidence may have a role in managing patients with refractory TNP. Key words: Trigeminal neuropathic pain, ultrasound-guided trigeminal nerve block, intermediate cervical plexus block :

scholarly journals Neuralgias of the Trigeminal Nerve

2000 ◽  
Vol 5 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Allan S Gordon
Keyword(s):  
Neuropathic Pain ◽  
Differential Diagnosis ◽  
Trigeminal Neuralgia ◽  
Clinical Features ◽  
Trigeminal Nerve ◽  
Postherpetic Neuralgia ◽  
Facial Pain ◽  
The Other ◽  
Atypical Facial Pain ◽  
Trigeminal Neuropathic Pain

Practitioners are often presented with patients who complain bitterly of facial pain. The trigeminal nerve is involved in four conditions that are sometimes mixed up. The four conditions - trigeminal neuralgia, trigeminal neuropathic pain, postherpetic neuralgia and atypical facial pain - are discussed under the headings of clinical features, differential diagnosis, cause and treatment. This article should help practitioners to differentiate one from the other and to manage their care.

scholarly journals Ultrasound-guided trigeminal nerve block for faciomaxillary surgeries

2017 ◽  
Vol 11 (2) ◽  
pp. 246 ◽  
Author(s):  
Chandni Sinha ◽  
Amarjeet Kumar ◽  
Ajeet Kumar ◽  
AkhileshKumar Singh
Keyword(s):  
Nerve Block ◽  
Trigeminal Nerve ◽  
Ultrasound Guided

Neurotropic Melanoma of the Trigeminal Nerve: A Case of Atypical Facial Pain

2008 ◽  
Vol 66 (3) ◽  
pp. 547-550 ◽  
Author(s):  
Hugh Walters ◽  
Emma Lewis ◽  
Regina Wolper ◽  
Anthony T. Yachnis ◽  
Jim Green ◽  
...  
Keyword(s):  
Trigeminal Nerve ◽  
Facial Pain ◽  
Atypical Facial Pain

Technical considerations for approaches to the ultrasound-guided maxillary nerve block via the pterygopalatine fossa: a literature review

2020 ◽  
Vol 45 (4) ◽  
pp. 301-305 ◽  
Author(s):  
Ariana Anugerah ◽  
Kim Nguyen ◽  
Antoun Nader
Keyword(s):  
Nerve Block ◽  
Trigeminal Nerve ◽  
Case Series ◽  
Pterygopalatine Fossa ◽  
Ultrasound Guided ◽  
Maxillary Nerve ◽  
Pubmed Database ◽  
Ideal Approach ◽  
Maxillary Nerve Block ◽  
The Ideal

Background and objectivesBlockade of the trigeminal nerve and its branches is an effective diagnostic tool and potential treatment of facial pain. Ultrasound-guided injections in the pterygopalatine fossa (PPF) to block the trigeminal nerve divisions and sphenopalatine ganglion have been described but a consensus has yet to be reached over the ideal approach. We sought to delineate and compare the various approaches to the ultrasound-guided trigeminal divisions blockade via the PPF.MethodsThe literature search was performed by searching the National Library of Medicine’s PubMed database, the Cochrane Database of Systematic Reviews and Google Scholar within the date range of January 2009–March 2019 for keywords targeted toward “trigeminal nerve,” “maxillary nerve,” or “pterygopalatine fossa,” “ultrasound,” and “nerve block,” using an English language restriction. Six papers were included in the final review: one prospective double-blinded randomized controlled trial, one prospective descriptive study, one case series, two case reports, and one cadaveric study.ResultsThere are three main approaches to the ultrasound-guided trigeminal nerve branches blockade via the PPF: anterior infrazygomatic in-plane, posterior infrazygomatic in-plane, and suprazygomatic out-of-plane approaches. Each showed injectate spread to the PPF in cadaver, adult and pediatric patients, respectively.1–5 Injectate used varied from 3 to 5 mL to 0.15 mL/kg.ConclusionsThese studies demonstrated that the PPF is a readily accessible target for the ultrasound-guided maxillary nerve block via three main approaches.2 The ideal approach is yet to be determined and must be further explored.

Trigeminal Neuralgia Secondary to a Tentorial Ossification: A Case Report

Neurosurgery ◽  
1982 ◽  
Vol 11 (4) ◽  
pp. 527-529 ◽  
Author(s):  
Michael Standefer ◽  
Janet W. Bay ◽  
Donald F. Dohn
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Posterior Fossa ◽  
Trigeminal Nerve ◽  
Facial Pain ◽  
Atypical Facial Pain ◽  
Tic Douloureux ◽  
Sensory Root ◽  
Unusual Symptoms

Abstract The authors describe a patient who suffered from tic douloureux associated with atypical facial pain and tinnitus. All preoperative neurodiagnostic findings were normal. Posterior fossa exploration disclosed a tentorial ossification compressing the sensory root of the trigeminal nerve. Ossification within the tentorium and the implications of unusual symptoms associated with trigeminal neuralgia are discussed.

scholarly journals Management of Chronic Facial Pain

2009 ◽  
Vol 2 (2) ◽  
pp. 67-76 ◽  
Author(s):  
Christopher G. Williams ◽  
A. Lee Dellon ◽  
Gedge D. Rosson
Keyword(s):  
Trigeminal Nerve ◽  
Successful Treatment ◽  
Facial Pain ◽  
Treatment Strategies ◽  
Atypical Facial Pain

Pain persisting for at least 6 months is defined as chronic. Chronic facial pain conditions often take on lives of their own deleteriously changing the lives of the sufferer. Although much is known about facial pain, it is clear that those physicians who treat these conditions should continue elucidating the mechanisms and defining successful treatment strategies for these life-changing conditions. This article will review many of the classic causes of chronic facial pain due to the trigeminal nerve and its branches that are amenable to surgical therapies. Testing of facial sensibility is described and its utility introduced. We will also introduce some of the current hypotheses of atypical facial pain and headaches secondary to chronic nerve compressions and will suggest possible treatment strategies.

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