Evidence-based approach to the medical management of trigeminal neuralgia

2007 ◽  
Vol 21 (3) ◽  
pp. 253-261 ◽  
Author(s):  
T. P. Jorns ◽  
J. M. Zakrzewska
Keyword(s):  
Trigeminal Neuralgia ◽  
Medical Management ◽  
Evidence Based

scholarly journals Experience with Conventional Radiofrequency Thermorhizotomy in Patients with Failed Medical Management for Trigeminal Neuralgia

2014 ◽  
Vol 27 (3) ◽  
pp. 260 ◽  
Author(s):  
Sarita Singh ◽  
Reetu Verma ◽  
Manoj Kumar ◽  
Virendra Rastogi ◽  
Jaishree Bogra
Keyword(s):  
Trigeminal Neuralgia ◽  
Medical Management

Abstract 1803: Catheterization without In-hospital Revascularization is Associated with Increased Long-term Mortality in Patients with Non-ST Elevation Myocardial Infarction and Significant Coronary Artery Disease

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Mark Y Chan ◽  
Kenneth W Mahaffey ◽  
Jie-Lena Sun ◽  
Karen S Pieper ◽  
Harvey D White ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Features ◽  
Medical Management ◽  
Significant Coronary Artery Disease ◽  
Evidence Based ◽  
St Elevation ◽  
Artery Disease

Background: Despite guidelines recommendations for early invasive management in non-ST-elevation myocardial infarction (NSTEMI), some patients (pts) with significant coronary artery disease (CAD) found on early angiography do not undergo revascularization. The prevalence, clinical features, and long-term prognosis of this population have not been well-characterized. Methods: We evaluated 8225 NSTEMI pts from the SYNERGY trial (2002–2004) with >50% stenosis in at least 1 epicardial artery who received in-hospital percutaneous coronary intervention (PCI), in-hospital coronary artery bypass grafting (CABG), or no revascularization before discharge (medical management). A propensity-adjusted Cox proportional hazards model was used to compare death/MI rates at 6 months and mortality rates at 1 year among the 3 subgroups starting from the time of hospital discharge. Results: A total of 2633 of 8255 pts (32%) were medically managed, 4294 (52%) underwent PCI, and 1298 (16%) underwent CABG. Clinical features and unadjusted outcomes are shown below. Guidelines-recommended discharge medications were used in a large proportion of patients, but those undergoing PCI most commonly received evidence-based therapies. The adjusted risk of 6-month death or MI was 2.19 (95% CI: 1.79–2.67) for medical management compared with PCI, and 3.07 (95% CI: 2.18 – 4.34) for medical management compared with CABG. The adjusted risks of 1-year mortality for medical management were 1.52 (95% CI: 1.07–2.17) and 1.70 (95% CI: 0.96–3.03), respectively. Conclusion: A substantial proportion of NSTEMI pts with significant CAD are managed medically without in-hospital revascularization. These pts have higher-risk clinical characteristics and worse outcomes compared with those who undergo PCI or CABG, despite fairly good use of evidence-based medications. Therefore, innovative treatment strategies are needed to mitigate the increased risk of adverse outcomes in this population. Baseline Characteristics, Discharge Medications, and Unadjusted Clinical Outcomes for the 3 Groups

Glossopharyngeal Neuralgia

2019 ◽  
pp. 23-30
Author(s):  
Oren Sagher
Keyword(s):  
Weight Loss ◽  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Medical Management ◽  
Treatment Modality ◽  
Primary Treatment ◽  
Glossopharyngeal Neuralgia ◽  
Pain Condition ◽  
Primary Treatment Modality ◽  
Posterior Tongue

Glossopharyngeal neuralgia is an uncommon, but devastating pain condition. It shares many features with trigeminal neuralgia, but predominantly affects the posterior tongue and pharynx. Since glossopharyngeal neuralgia pain is frequently triggered by swallowing or movement of the tongue, patients frequently present with weight loss and dehydration. This chapter describes the classic features of this condition, including its association with syncope. The medical management of glossopharyngeal neuralgia is outlined as a primary treatment modality. Surgical considerations are also described, including microvascular decompression or sectioning of the glossopharyngeal nerve. Surgical pearls for both of these procedures are outlined, as well as strategies for complication avoidance and management.

scholarly journals 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn’s Disease 2016: Part 1: Diagnosis and Medical Management

2016 ◽  
Vol 11 (1) ◽  
pp. 3-25 ◽  
Author(s):  
Fernando Gomollón ◽  
Axel Dignass ◽  
Vito Annese ◽  
Herbert Tilg ◽  
Gert Van Assche ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Medical Management ◽  
Evidence Based ◽  
Diagnosis And Management

An Evidence-based Approach to the Medical Management of Fibroids

2016 ◽  
Vol 59 (1) ◽  
pp. 30-52 ◽  
Author(s):  
CHANTAL B. BARTELS ◽  
KAMARIA C. CAYTON ◽  
FARAH S. CHUONG ◽  
KRISTINE HOLTHOUSER ◽  
SARA A. MEHR ◽  
...  
Keyword(s):  
Medical Management ◽  
Evidence Based

scholarly journals Correlation of Trigeminopontine Angle with Severity of Trigeminal Neuralgia due to Neurovascular conflict over medial aspect of nerve. Can we prognosticate the reduction in pain in patients on medical management?

2021 ◽  
Author(s):  
Pundalik Umalappa Lamani ◽  
Abhishek J Arora ◽  
Kiran Kumar Reddy Kona ◽  
Jyotsna Yarlagadda
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Medical Management ◽  
Rating Scale ◽  
Treatment Plan ◽  
Statistical Significance ◽  
Poor Response ◽  
Post Treatment ◽  
Medial Aspect ◽  
Neurovascular Conflict

Abstract Background: Neurovascular conflicts (NVC) are one of the major causative factors in patients presenting with Trigeminal neuralgia (TN). We found great degree of variation in acuteness of medial trigeminopontine angle (mTPA), angle between medial border of trigeminal nerve and anterior border of pons in patients with TN and tried to find its correlation with pain severity due to NVC over the medial aspect of nerve (mNVC).Aims and Objectives: To Correlate mTPA measurement with severity of trigeminal neuralgia due to mNVC. To calculate the reduction in pain in patients kept on medical management and its correlation with medial trigeminopontine angle.Material and Methods: This was a retrospective observational study conducted between May 2018 to October 2020. A total of 41 patients presenting with Trigeminal Neuralgia and showing corresponding Neurovascular conflict were included in the study. Out of the total cases with NVC, 30 cases showed NVC over the medial surface of the nerve. All the patients were evaluated on MAGNETOM Skyra 3T MRI (Siemens). Using Two-line Cobb angle method, trigeminopontine angle was calculated. Pre-treatment pain intensity and post treatment pain relief of each patients were assessed by using numeric rating scale (NRS). NRS with numbers from 0 to 10 (‘no pain’ to ‘worst pain imaginable’). Relevant clinical details regarding pre- and post-treatment pain score as well as treatment plan opted by patients were collected.Results: Patients with post treatment response ≥ 50% is considered as “good response” and < 50% is considered as “poor response”. In our study with trigeminopontine angle threshold of 45 degree, 7 out of 8 (87.5%) patients with > 450 mTPA showed poor response and 15/22 (68.2%) patients ≤ 450 showed good response to medical management for trigeminal neuralgia due to mNVC with statistical significance difference with p-valve of 0.007Conclusion: In our study, we found a negative correlation between the mTPA and percentage pain relief in patients kept on medical management. We realised that mTPA measurement could become an important tool for prognosticating pain relief for patients of trigeminal neuralgia on medical therapy.

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