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

scholarly journals Percutaneous radiofrequency rhizotomy and neurovascular decompression of the trigeminal nerve for the treatment of facial pain

2006 ◽  
Vol 64 (4) ◽  
pp. 983-989 ◽  
Author(s):  
Manoel J. Teixeira ◽  
Silvia R.D.T. Siqueira ◽  
Gilberto M. Almeida
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Success Rate ◽  
Facial Pain ◽  
Clinical Findings ◽  
Atypical Facial Pain ◽  
Post Herpetic Neuralgia ◽  
Trigeminal Neuropathy ◽  
Idiopathic Trigeminal Neuralgia ◽  
Neurovascular Decompression

OBJECTIVE: To determine the outcomes of 354 radiofrequency rhizotomies and 21 neurovascular decompressions performed as treatment for 367 facial pain patients (290 idiopathic trigeminal neuralgia, 52 symptomatic trigeminal neuralgia, 16 atypical facial pain, 9 post-herpetic neuralgia). METHOD: Clinical findings and surgery success rate were considered for evaluation. A scale of success rate was determined to classify patients, which considered pain relief and functional/sensorial deficits. RESULTS: Radiofrequency rhizotomy was performed in 273 patients with idiopathic trigeminal neuralgia and in all other patients, except for trigeminal neuropathy; neurovascular decompression was performed in 18 idiopathic trigeminal neuralgia patients; 100% idiopathic trigeminal neuralgia, 96.2% symptomatic trigeminal neuralgia, 37.5% atypical facial pain and 88.9% post-herpetic neuralgia had pain relief. CONCLUSION: Both techniques for idiopathic trigeminal neuralgia are usefull. Radiofrequency rhizotomy was also efficient to treat symptomatic facial pain, and post-herpetic facial pain, but is not a good technique for atypical facial pain.

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: A Case Report

2018 ◽  
Vol 31 (04) ◽  
pp. 254-258
Author(s):  
Shruti Jain ◽  
Chetna Lamba
Keyword(s):  
Case Report ◽  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Conventional Medicine ◽  
Positive Role ◽  
Idiopathic Trigeminal Neuralgia ◽  
Adequate Pain Relief ◽  
The Face

AbstractTrigeminal neuralgia (TN) is the most frequent type of neuropathic facial pain affecting one or more branches of trigeminal nerve. Here, a 51-year-old woman diagnosed with idiopathic trigeminal neuralgia (ITN) presented with complaints of pain over right side of the face with redness of the eyes and excessive lachrymation since 5 years with weekly acute episodes of shooting pain. Chelidonium was chiefly prescribed followed by few doses of Spigelia as per indications which provided adequate pain relief. The complaints flared up following stressful circumstances for which Pulsatilla was prescribed after detailed case taking. The frequency, duration and intensity of pain reduced after homoeopathic treatment. The need for conventional medicine was also reduced. This suggests positive role of individualised homoeopathy in the treatment of ITN. Further studies should be undertaken to evaluate the role of homoeopathy in ITN.

Trigeminal neuralgia or atypical facial pain

1996 ◽  
Vol 82 (4) ◽  
pp. 361-362 ◽  
Author(s):  
Martin S. Greenberg
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Atypical Facial Pain

scholarly journals Radiofrequency Thermoablation of the Gasserian Ganglion Versus the Peripheral Branches of the Trigeminal Nerve for Treatment of Trigeminal Neuralgia: A Randomized, Control Trial

2019 ◽  
Vol 2 (22.2) ◽  
pp. 147-154
Author(s):  
Neerja Bharti
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Facial Pain ◽  
Control Group ◽  
Study Group ◽  
Gasserian Ganglion ◽  
Idiopathic Trigeminal Neuralgia ◽  
Radiofrequency Thermoablation

Background: Trigeminal neuralgia is the most painful condition of facial pain leading to impairment of routine activities. Although radiofrequency thermoablation (RFT) of the Gasserian ganglion is widely used for the treatment of idiopathic trigeminal neuralgia in patients having ineffective pain relief with medical therapy, the incidence of complications like hypoesthesia, neuroparalytic keratitis, and masticatory muscles weakness is high. Recent case reports have shown the effectiveness of RFT of the peripheral branches of the trigeminal nerve for relief of refractory chronic facial pain conditions including trigeminal neuralgia. Objectives: This study was conducted to compare the efficacy and safety of RFT of the peripheral branches of the trigeminal nerve with RFT of the Gasserian ganglion for the management of idiopathic trigeminal neuralgia. Study Design: Prospective, randomized, observer-blinded, clinical trial. Setting: Tertiary care hospital and medical education and research institute. Methods: A total of 40 adult patients of idiopathic trigeminal neuralgia were randomly allocated into 2 groups. The control group received RFT of the Gasserian ganglion while the study group received RFT of the peripheral branches of trigeminal nerve. The procedures were performed in the operation room under all aseptic precautions with fluoroscopic guidance. Post-procedure, the patients were assessed for loss of sensation along the nerve distribution and the adequacy of pain relief on the Numerical Rating Scale (NRS). The patients were followed up for 3 month to assess the quality of pain relief by the NRS and the Barrow Neurological Institute (BNI) pain intensity scale. Improvement in pain was considered excellent if patients had complete pain relief without any medication, good if there was significant reduction in pain (> 50%) with or without medication, and poor if there was less than 50% reduction in pain with medications. Patients were also assessed for numbness and any other side effects. Patients’ satisfaction with the procedure was recorded. Results: Nineteen patients in the control group and 18 in study group had effective pain relief of up to 3 months. Their pain scores were comparable at all time intervals, though the number of patients receiving supplementary medications was more in study group at 2 months (P = 0.015). The patients showed overall satisfaction score of 8.5 (8-9) and 8 (7-9) in control and study groups respectively. The average procedure duration was 30 (30-38) minutes in the control group and 28 (25-40) minutes in the study group. Most of the patients in both groups had mild numbness after the procedure. One patient in the control group had lower eyelid swelling and another had mild weakness of the masseter muscle, which resolved few days later. No major complication was reported in the study group except for 1 patient who reported local ecchymosis. Limitations: The main limitation of the study is that the patients and the investigator performing the procedure were not blinded, though the person who assessed the patient during follow-up was blinded to the group assignment. Another limitation is that we could not follow up with the patients after 3 months due to time constraints. Conclusion: We found that radiofrequency thermoablation of the peripheral branches of the trigeminal nerve is an effective and safe procedure for the management of idiopathic trigeminal neuralgia. Key words: Idiopathic trigeminal neuralgia, radiofrequency thermoablation, Gasserian ganglion, peripheral nerve branches, pain, trigeminal nerve

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.

A New Classification for Facial Pain

Neurosurgery ◽  
2003 ◽  
Vol 53 (5) ◽  
pp. 1164-1167 ◽  
Author(s):  
Kim J. Burchiel
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Classification Scheme ◽  
Unintentional Injury ◽  
Atypical Facial Pain ◽  
New Classification ◽  
Somatoform Pain Disorder ◽  
Constant Pain ◽  
Diagnostic Labels ◽  
Patient’S History

Abstract PURPOSE A patient-oriented classification scheme for facial pains commonly encountered in neurosurgical practice is proposed. CONCEPT This classification is driven principally by the patient's history. RATIONALE The scheme incorporates descriptions for so-called “atypical” trigeminal neuralgias and facial pains but minimizes the pejorative, accepting that the physiology of neuropathic pains could reasonably encompass a variety of pain sensations, both episodic and constant. Seven diagnostic labels result: trigeminal neuralgia Types 1 and 2 refer to patients with the spontaneous onset of facial pain and either predominant episodic or constant pain, respectively. Trigeminal neuropathic pain results from unintentional injury to the trigeminal nerve from trauma or surgery, whereas trigeminal deafferentation pain results from injury to the nerve by peripheral nerve ablation, gangliolysis, or rhizotomy in an intentional attempt to treat either trigeminal neuralgia or other facial pain. Postherpetic neuralgia follows a cutaneous herpes zoster outbreak (shingles) in the trigeminal distribution, and symptomatic trigeminal neuralgia results from multiple sclerosis. The final category, atypical facial pain, is synonymous with facial pain secondary to a somatoform pain disorder. Atypical facial pain can be suspected but not diagnosed by history and can be diagnosed only with detailed and objective psychological testing. CONCLUSION This diagnostic classification would allow more rigorous and objective natural history and outcome studies of facial pain in the future.

Trigeminal Neuralgia and Atypical Facial Pain

2012 ◽  
pp. 398-413
Author(s):  
Trang Nguyen ◽  
Pablo F. Recinos ◽  
Michael Lim
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Atypical Facial Pain

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...

Association between paroxysmal trigeminal neuralgia and atypical facial pain

1999 ◽  
Vol 37 (6) ◽  
pp. 444-447 ◽  
Author(s):  
R.P. Juniper ◽  
C.J. Glynn
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Atypical Facial Pain
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