Facial pain and palsy

2005 ◽  
pp. 185-211
Author(s):  
Patricia Sylla
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Glossopharyngeal Neuralgia ◽  
Atypical Facial Pain ◽  
Temporomandibular Dysfunction ◽  
Anatomy And Physiology ◽  
Tic Douloureux ◽  
Pain Syndromes ◽  
Idiopathic Pain

Anatomy and physiology of pain 186 Anatomy and physiology of oro-facial pain 187 Oro-facial (idiopathic) pain syndromes 188 Overview of oro-facial pain 190 Assessment and measurement of pain 192 Temporomandibular dysfunction (TMJPDS) 196 Atypical facial pain 202 Trigeminal neuralgia ('tic douloureux') 204 Glossopharyngeal neuralgia 206...

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 Trigeminal neuralgia: definition and classification

2005 ◽  
Vol 18 (5) ◽  
pp. 1-3 ◽  
Author(s):  
Jorge L. Eller ◽  
Ahmed M. Raslan ◽  
Kim J. Burchiel
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Classification Scheme ◽  
Unintentional Injury ◽  
Atypical Facial Pain ◽  
Trigeminal Neuropathic Pain ◽  
Somatoform Pain Disorder ◽  
Pain Syndromes ◽  
Specific Objective ◽  
Patient’S History

Based on specific, objective, and reproducible criteria, a classification scheme for trigeminal neuralgia (TN) and related facial pain syndromes is proposed. Such a classification scheme is based on information provided in the patient's history and incorporates seven diagnostic criteria, as follows. 1) and 2) Trigeminal neuralgia Types 1 and 2 (TN1 and TN2) refer to idiopathic, spontaneous facial pain that is either predominantly episodic (as in TN1) or constant (as in TN2) in nature. 3) Trigeminal neuropathic pain results from unintentional injury to the trigeminal nerve from trauma or surgery. 4) Trigeminal deafferentation pain results from intentional injury to the nerve by peripheral nerve ablation, gangliolysis, or rhizotomy in an attempt to treat either TN or other related facial pain. 5) Symptomatic TN results from multiple sclerosis. 6) Postherpetic TN follows a cutaneous herpes zoster outbreak in the trigeminal distribution. 7) The category of atypical facial pain is reserved for facial pain secondary to a somatoform pain disorder and requires psychological testing for diagnostic confirmation. The purpose of a classification scheme like this is to advocate a more rigorous, standardized natural history and outcome studies for TN and related facial pain syndromes.

Computed Tomography-guided Percutaneous Trigeminal Tractotomy-nucleotomy

2008 ◽  
Vol 63 (suppl_1) ◽  
pp. ONS147-ONS155 ◽  
Author(s):  
Yucel Kanpolat ◽  
Gokmen Kahilogullari ◽  
Hasan C. Ugur ◽  
Atilla H. Elhan
Keyword(s):  
Computed Tomography ◽  
Trigeminal Neuralgia ◽  
Cancer Pain ◽  
Facial Pain ◽  
Karnofsky Performance Scale ◽  
Atypical Facial Pain ◽  
Minimal Invasiveness ◽  
Pain Syndromes ◽  
Scale Scores ◽  
Vagoglossopharyngeal Neuralgia

Abstract Objective: The destruction of the descending trigeminal tractus in the medulla is known as trigeminal tractotomy (TR), whereas the lesioning of the nucleus caudalis is known as trigeminal nucleotomy (NC). Trigeminal TR and/or NC procedures can be used in a large group of pain syndromes, such as glossopharyngeal, vagal, and geniculate neuralgias, atypical facial pain, craniofacial cancer pain, postherpetic neuralgias, and atypical forms of trigeminal neuralgia. Methods: In this study, anatomic and technical details of the procedure and the experience gained from 65 patients over the course of 20 years are discussed. Patients’ pain scores and Karnofsky Performance Scale scores were evaluated pre- and postoperatively (postoperative Day 1). Results: The best results were obtained in the second-largest group (vagoglossopharyngeal neuralgia, n = 17) and in geniculate neuralgia (n = 4). Patients with atypical facial pain (n = 21; 13 women, eight men) accounted for the largest group to undergo computed tomography-guided TR-NC surgery; pain relief was achieved in 19 of these patients. In the third-largest group (craniofacial and oral cancer pain, n = 13), 11 of 13 patients were successfully treated with TR-NC. Four of five patients with failed trigeminal neuralgia were also effectively treated with TR-NC. Conclusion: We propose that computed tomography-guided TR-NC provides direct visualization of the target-electrode relation and can be considered a first-step procedure in patient management. In view of its high efficacy, low complication rate, and minimal invasiveness, computed tomography-guided trigeminal TR-NC is a safe and effective procedure in the treatment of intractable facial pain syndromes.

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.

Idiopathic Trigeminal Neuralgia Associated with a Severe Atypical Facial Pain Exacerbated by Hydrocephalus 

1999 ◽  
Vol 91 (6) ◽  
pp. 1968-1968 ◽  
Author(s):  
Masako Iseki ◽  
Hiromasa Mitsuhata ◽  
Yutaka Tanabe ◽  
Toyo Miyazaki
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Atypical Facial Pain ◽  
Idiopathic Trigeminal Neuralgia

Association of vascular compression in trigeminal neuralgia versus other “facial pain syndromes” by magnetic resonance imaging

1991 ◽  
Vol 36 (6) ◽  
pp. 447-452 ◽  
Author(s):  
Nevan G. Baldwin ◽  
K.Singh Sahni ◽  
Mary E. Jensen ◽  
Daniel R. Pieper ◽  
Randy L. Anderson ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Vascular Compression ◽  
Resonance Imaging ◽  
Pain Syndromes

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 Comparison of Trigeminal and Postherpetic Neuralgia

1996 ◽  
Vol 1 (2) ◽  
pp. 125-129
Author(s):  
C Peter N Watson
Keyword(s):  
Trigeminal Neuralgia ◽  
Postherpetic Neuralgia ◽  
Facial Pain ◽  
Tic Douloureux ◽  
Common Causes ◽  
The Face ◽  
Lancinating Pain

Although postherpetic neuralgia and trigeminal neuralgia (tic douloureux) are common causes of facial pain, they have very little in common aside from lancinating pain (other qualities of pain in each disorder are different). Each disorder affects different areas of the face and the treatment of each is quite dissimilar. The pathogenesis of these two disorders quite likely involves different mechanisms. This report reviews aspects of these two difficult pain problems, particularly with reference to the work of the late Gerhard Fromm, to whom this is dedicated.

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