scholarly journals Trigeminal neuralgia: a practical guide

2021 ◽  
pp. practneurol-2020-002782
Author(s):  
Giorgio Lambru ◽  
Joanna Zakrzewska ◽  
Manjit Matharu
Keyword(s):  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Neurovascular Conflict ◽  
Medical Treatments ◽  
First Choice ◽  
Diagnostic Work ◽  
Surgical Treatments ◽  
Work Up

Trigeminal neuralgia (TN) is a highly disabling disorder characterised by very severe, brief and electric shock like recurrent episodes of facial pain. New diagnostic criteria, which subclassify TN on the basis of presence of trigeminal neurovascular conflict or an underlying neurological disorder, should be used as they allow better characterisation of patients and help in decision-making regarding medical and surgical treatments. MR, including high-resolution trigeminal sequences, should be performed as part of the diagnostic work-up. Carbamazepine and oxcarbazepine are drugs of first choice. Lamotrigine, gabapentin, pregabalin, botulinum toxin type A and baclofen can be used either alone or as add-on therapy. Surgery should be considered if the pain is poorly controlled or the medical treatments are poorly tolerated. Trigeminal microvascular decompression is the first-line surgery in patients with trigeminal neurovascular conflict while neuroablative surgical treatments can be offered if MR does not show any neurovascular contact or where patients are considered too frail for microvascular decompression or do not wish to take the risk.

scholarly journals Neurapraxia in patients with trigeminal neuralgia but no identifiable neurovascular conflict during microvascular decompression: a retrospective analysis of 26 cases

BMC Surgery ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Juan Li ◽  
Min Zhou ◽  
Yuhai Wang ◽  
Sze Chai Kwok ◽  
Jia Yin
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Herpes Labialis ◽  
Efficacy And Safety ◽  
Neurovascular Conflict ◽  
Aneurysm Clip ◽  
First Choice ◽  
Trigeminal Nerve Root

Abstract Background Microvascular decompression (MVD) is the first choice in patients with classic trigeminal neuralgia (TGN) that could not be sufficiently controlled by pharmacological treatment. However, neurovascular conflict (NVC) could not be identified during MVD in all patients. To describe the efficacy and safety of treatment with aneurysm clips in these situations. Methods A total of 205 patients underwent MVD for classic TGN at our center from January 1, 2015 to December 31, 2019. In patients without identifiable NVC upon dissection of the entire trigeminal nerve root, neurapraxia was performed using a Yasargil temporary titanium aneurysm clip (force: 90 g) for 40 s (or a total of 60 s if the process must be suspended temporarily due to bradycardia or hypertension). Results A total of 26 patients (median age: 64 years; 15 women) underwent neurapraxia. Five out of the 26 patients received prior MVD but relapsed. Immediate complete pain relief was achieved in all 26 cases. Within a median follow-up of 3 years (range: 1.0–6.0), recurrence was noted in 3 cases (11.5%). Postoperative complications included hemifacial numbness, herpes labialis, masseter weakness; most were transient and dissipated within 3–6 months. Conclusions Neurapraxia using aneurysm clip is safe and effective in patients with classic TGN but no identifiable NVC during MVD. Whether this method could be developed into a standardizable method needs further investigation.

APPLICATION OF BOTULINUM TOXIN TYPE A FOR PAIN REDUCTION IN TRIGEMINAL NEURALGIA - 6 - MONTH FOLLOW-UP

2021 ◽  
pp. 15-19
Author(s):  
Maristela Corrêa de Lima ◽  
Célia Marisa Rizzatti Barbosa ◽  
Paulo Henrique Ferreira Caria
Keyword(s):  
Botulinum Toxin ◽  
Trigeminal Neuralgia ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Pain Reduction

Acute aortic syndrome: aortic dissection—ascending aortic dissection

ESC CardioMed ◽  
2018 ◽  
pp. 2594-2597
Author(s):  
Christoph T. Starck ◽  
Robert Hammerschmidt ◽  
Volkmar Falk
Keyword(s):  
Aortic Dissection ◽  
Imaging Method ◽  
Intramural Haematoma ◽  
Acute Aortic Syndrome ◽  
Penetrating Aortic Ulcer ◽  
Chest Computed Tomography ◽  
First Choice ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Aortic dissection, intramural haematoma, and penetrating aortic ulcer can each present as an acute aortic syndrome. If left untreated, acute aortic syndrome carries a high mortality. Therefore, rapid diagnostic work-up and appropriate surgical therapy are of utmost importance. Chest computed tomography is the imaging method of first choice.

Injections of Botulinum Toxin Type A Produce Pain Alleviation in Intractable Trigeminal Neuralgia

2005 ◽  
Vol 21 (2) ◽  
pp. 182-184 ◽  
Author(s):  
Nasser Allam ◽  
Joaquim P. Brasil-Neto ◽  
Gilberto Brown ◽  
Carlos Tomaz
Keyword(s):  
Botulinum Toxin ◽  
Trigeminal Neuralgia ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type

scholarly journals Botulinum Toxin Type A for refractory trigeminal neuralgia in older patients: a better therapeutic effect

2019 ◽  
Vol Volume 12 ◽  
pp. 2177-2186 ◽  
Author(s):  
Shouyi Wu ◽  
Yajun Lian ◽  
Haifeng Zhang ◽  
Yuan Chen ◽  
Chuanjie Wu ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Trigeminal Neuralgia ◽  
Therapeutic Effect ◽  
Older Patients ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type

scholarly journals Role of Botulinum Toxin Type-A (BTX-A) in the Management of Trigeminal Neuralgia

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Gaurav Verma
Keyword(s):  
Botulinum Toxin ◽  
Trigeminal Neuralgia ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Review Of The Literature ◽  
The Past ◽  
Permanent Cure ◽  
Variable Success

Trigeminal neuralgia (TN) is a clinical condition characterized by paroxysmal attacks of severe and electric shock-like pain along the distribution of one or more branches of the trigeminal nerve. Various medicinal or surgical modalities have been employed in the past with variable success. Newer methods were tried in search of permanent cure or long-lasting pain relief. The purpose of this paper is to present the review of the literature regarding the use of botulinum toxin type-A (BTX-A) in the management of trigeminal neuralgia.

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