scholarly journals Severe Headache with Eye Involvement from Herpes Zoster Ophthalmicus, Trigeminal Tract, and Brainstem Nuclei

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Sasitorn Siritho ◽  
Wadchara Pumpradit ◽  
Wiboon Suriyajakryuththana ◽  
Krit Pongpirul
Keyword(s):  
Trigeminal Nerve ◽  
Maculopapular Rash ◽  
Cervical Cord ◽  
Gasserian Ganglion ◽  
Herpes Zoster Ophthalmicus ◽  
Trigeminal Nuclei ◽  
Upper Cervical ◽  
Sensory Nucleus ◽  
The Right ◽  
Orbital Imaging

A 43-year-old female presented with severe sharp stabbing right-sided periorbital and retroorbital area headache, dull-aching unilateral jaw pain, eyelid swelling, ptosis, and tearing of the right eye but no rash. The pain episodes lasted five minutes to one hour and occurred 10–15 times per day with unremitting milder pain between the attacks. She later developed an erythematous maculopapular rash over the right forehead and therefore was treated with antivirals. MRI performed one month after the onset revealed small hypersignal-T2 in the right dorsolateral mid-pons and from the right dorsolateral aspect of the pontomedullary region to the right dorsolateral aspect of the upper cervical cord, along the course of the principal sensory nucleus and spinal nucleus of the right trigeminal nerve. No definite contrast enhancement of the right brain stem/upper cervical cord was seen. Orbital imaging showed no abnormality of bilateral optic nerves/chiasm, extraocular muscles, and globes. Slight enhancement of the right V1, V2, and the cisterna right trigeminal nerve was detected. Our findings support the hypothesis of direct involvement by virus theory, reflecting rostral viral transmission along the gasserian ganglion to the trigeminal nuclei at brainstem and caudal spreading along the descending tract of CN V.

scholarly journals Arteriovenous malformation of the trigeminal nerve root presented with venous congestive edema of the medulla oblongata and upper cervical cord: illustrative case

2021 ◽  
Vol 2 (9) ◽  
Author(s):  
Arata Nagai ◽  
Hidenori Endo ◽  
Kenichi Sato ◽  
Tomohiro Kawaguchi ◽  
Hiroki Uchida ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Medulla Oblongata ◽  
Trigeminal Nerve ◽  
Nerve Root ◽  
Venous Hypertension ◽  
Cervical Cord ◽  
Illustrative Case ◽  
Trigeminal Nerve Root ◽  
Upper Cervical ◽  
The Right

BACKGROUND Arteriovenous malformation (AVM) of the trigeminal nerve root (TNR) is a rare subtype of the lateral pontine AVM. Most of them are diagnosed when they bleed or exert trigeminal neuralgia. Venous congestive edema is a rare phenomenon caused by TNR AVMs. OBSERVATIONS An 82-year-old man was admitted with progressive limb weakness and dysphasia. Magnetic resonance imaging (MRI) revealed extensive edema of the medulla oblongata and the upper cervical cord with signal flow void at the C3 anterior spinal cord. Vertebral angiography revealed a small nidus fed mainly by the pontine perforating arteries (PPAs). The anterior pontomesencephalic vein (AMPV) was dilated, functioning as the main drainage route. This suggests that venous hypertension triggered the brainstem and upper cervical cord edema. MRI with gadolinium enhancement showed that the nidus was located around the right TNR. Because the nidus sat extrinsically on the pial surface of the right TNR’s base, microsurgical obliteration with minimum parenchymal injury was achieved. Postoperative MRI showed disappearance of the brainstem and cervical cord edema with improved clinical symptoms. LESSONS TNR AVM is rarely associated with brainstem and upper cervical cord edema caused by venous hypertension of the congestive drainage system.

Lingual Mechanoreceptive Information II

1982 ◽  
Vol 25 (3) ◽  
pp. 357-363
Author(s):  
James P. Bowman
Keyword(s):  
Trigeminal Nerve ◽  
Somatosensory System ◽  
Single Pulse ◽  
Lingual Nerve ◽  
Medial Lemniscus ◽  
Trigeminal Nuclei ◽  
Sensorimotor Activity ◽  
Contralateral Projection ◽  
Sensory Nucleus ◽  
Ipsilateral Projection

The extent to which the known trigeminothalamic projections are related to afferents from specific peripheral branches of the trigeminal nerve is not clearly revealed by degeneration studies involving lesions of the various trigeminal nuclei. This study examines the ascending projections related to the lingual branch of the trigeminal nerve using the evoked-potential technique in pentobarbital anesthetized rhesus monkeys. The distribution of potentials within the medulla, pons, and midbrain was determined by recording with macroelectrodes following single-pulse stimulation of the lingual nerve. Results show that two pathways from the main sensory nucleus convey lingual nerve information to the thalamic ventral posteromedial nucleus: an ipsilateral projection which in position corresponds to the dorsal trigeminal tract, and a larger contralateral projection which in position corresponds to the crossed ventral trigeminal tract, or trigeminal lemniscus. Additionally, the spinal trigeminal nucleus contributes fibers of lingual nerve origin to the contralateral medial lemniscus. The role of low-threshold mechanoreceptive information in lingual sensorimotor activity is discussed in relation to current concepts of somatosensory system function.

scholarly journals Trigeminal Neuralgia associated with Wallenberg Syndrome, a case report

2021 ◽  
Author(s):  
Matheus Goncalves Maia ◽  
Vivian Dias Baptista Gagliardi ◽  
Francisco Tomaz Meneses Oliveira ◽  
Eduardo dos Santos Sousa ◽  
Marina Trombin Marques ◽  
...  
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Vascular Compression ◽  
Gasserian Ganglion ◽  
Entry Zone ◽  
Root Entry Zone ◽  
Initial Event ◽  
The Right ◽  
The Brain

Context: Trigeminal neuralgia is typically associated with structural lesions that affect the brainstem, pre-ganglionic roots, gasserian ganglion and the trigeminal nerve. The association of trigeminal neuralgia with infarction of the dorsolateral medulla is rare, being more associated with pontine lesions, in the context of brainstem infarction. Methods: Report the case of a 55-year-old male patient, who presented with a left dorsolateral bulbar infarction, and developed a ipsilateral trigeminal neuralgia afterwards. Case report: A 55-year-old man attended to the emergency room referring sudden incoordination of the left limbs, associated with numbness of the contralateral limbs. The neurological examination showed nystagmus, numbness of the left face, ataxia of the left limbs and numbness of the right limbs. The Magnetic Resonance of the Brain revealed an area of recent infarction in the left posterolateral aspect of the medulla. He underwent thrombolysis, evolving with complete resolution of symptoms. In the week after the initial event, he returned to the outpatient clinic, reporting paroxysms of excruciating pain in the upper lip, nose and left zygomatic region, being diagnosed with neuralgia of the maxillary segment of the trigeminal nerve, improving with introduction of Gabapentin. Conclusion: Although most cases of trigeminal neuralgia are determined by vascular compression of the trigeminal nerve root entry zone, other causes must be considered. The association of this condition with dorsolateral medulla infarction is rare, with only 4 cases reported in the last 10 years.

scholarly journals Neurotrophic Keratopathy after Trigeminal Nerve Block for Treatment of Postherpetic Neuralgia

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Aya Kodama-Takahashi ◽  
Koji Sugioka ◽  
Tomoko Sato ◽  
Koichi Nishida ◽  
Keiichi Aomatsu ◽  
...  
Keyword(s):  
Nerve Block ◽  
Trigeminal Nerve ◽  
Postherpetic Neuralgia ◽  
Nerve Fibers ◽  
Gasserian Ganglion ◽  
Ganglion Block ◽  
Corneal Epithelial ◽  
Corneal Sensation ◽  
The Right ◽  
Neurotrophic Keratopathy

Purpose. To report a case of persistent corneal epithelial defect that had occurred after a trigeminal nerve block. Case Presentation. A 75-year-old female had suffered from postherpetic neuralgia for 8 years. She underwent Gasserian ganglion block surgery and noticed declining visual acuity in the right eye on the following day. She presented with severe hyperemia and corneal epithelial defects in the right eye and experienced remarkable reduction of sensitivity in the right cornea. She was diagnosed with neurotrophic keratopathy. Ofloxacin eye ointment and rebamipide ophthalmic suspension ameliorated the corneal epithelial defects but superficial punctate keratopathy, corneal superficial neovascularization, and Descemet’s fold persisted. Although the epithelial defects occasionally recurred, the corneal sensation and epithelial defects, Descemet’s fold, and corneal superficial neovascularization all improved around 5 months after trigeminal nerve block. The HRT II Rostock Cornea Module (RCM) could not detect any corneal subbasal nerve fibers at postoperative 4 months; however, it could detect them at postoperative 6 months. Conclusions. As the nerve block effect wore off, the corneal subbasal nerve fibers slowly regenerated. As the corneal sensation improved, the corneal epithelial defects and superficial neovascularization also improved. The HRT II RCM appeared useful for observing loss and regeneration of the corneal subbasal nerve fibers.

Unilateral Upper Cervical Cord Infarct Restricted to the Right Funiculus Cuneatus

2008 ◽  
Vol 47 (5) ◽  
pp. 479-479 ◽  
Author(s):  
Yukio Iwanaka ◽  
Kazumasa Okada ◽  
Yuko Tanaka ◽  
Utako Takechi ◽  
Sadatoshi Tsuji
Keyword(s):  
Cervical Cord ◽  
Upper Cervical ◽  
The Right

scholarly journals *Autopsy of a suspected venous circulatory disturbance localized in the medulla oblongata and upper cervical cord accompanied with an aneurysm

2008 ◽  
Vol 48 (8) ◽  
pp. 568-574
Author(s):  
Katsuhisa Masaki ◽  
Masaharu Ohno ◽  
Hironobu Maeda ◽  
Tetsuo Hamada ◽  
Toru Iwaki ◽  
...  
Keyword(s):  
Medulla Oblongata ◽  
Cervical Cord ◽  
Circulatory Disturbance ◽  
Upper Cervical

Ascending pathways in the spinal cord involved in the activation of subnucleus reticularis dorsalis neurons in the medulla of the rat

1990 ◽  
Vol 63 (3) ◽  
pp. 424-438 ◽  
Author(s):  
Z. Bing ◽  
L. Villanueva ◽  
D. Le Bars
Keyword(s):  
Spinal Cord ◽  
Electrical Stimulation ◽  
The Body ◽  
Cervical Cord ◽  
Lateral Part ◽  
Neuronal Responses ◽  
C Fiber ◽  
Dorsal Columns ◽  
Dorsolateral Funiculus ◽  
The Right

1. Recordings were made from neurons in the left medullary subnucleus reticularis dorsalis (SRD) of anesthetized rats. Two populations of neurons were recorded: neurons with total nociceptive convergence (TNC), which gave responses to A delta- and C-fiber activation from the entire body after percutaneous electrical stimulation, and neurons with partial nociceptive convergence (PNC), which responded to identical stimuli with an A delta-peak regardless of which part of the body was stimulated and with a C-fiber peak of activation from some, mainly contralateral, parts of the body. 2. The effects of various, acute, transverse sections of the cervical (C4-C5) spinal cord on the A delta- and C-fiber-evoked responses were investigated by building poststimulus histograms (PSHs) after 50 trials of supramaximal percutaneous electrical stimulation of the extremity of either hindpaw (2-ms duration; 3 times threshold for C-fiber responses), before and 30-40 min after making the spinal lesion. 3. In the case of TNC neurons, hemisections of the left cervical cord blocked the responses elicited from the right hindpaw and slightly, but not significantly, diminished those evoked from the left hindpaw. Conversely, hemisections of the right cervical cord abolished TNC responses elicited from the left hindpaw without significantly affecting the responses elicited from the right hindpaw. 4. Lesioning the dorsal columns or the left dorsolateral funiculus was found not to affect the TNC neuronal responses elicited from either hindpaw. By contrast, lesioning the left lateral funiculus or the most lateral part of the ventrolateral funiculus, respectively, reduced and blocked the responses elicited from the right hindpaw without affecting those evoked from the left hindpaw. 5. After lesions that included the most lateral parts of the left ventral funiculus, PNC neuronal responses elicited from the right hindpaw were also abolished, whereas those elicited from the left hindpaw remained unchanged. 6. We conclude that the signals responsible for the activation of SRD neurons travel principally in the lateral parts of the ventrolateral quadrant, a region that classically has been implicated in the transmission of noxious information. Both a crossed and a double-crossed pathway are involved in this process. The postsynaptic fibers of the dorsal columns and the spinocervical and spinomesencephalic tracts do not appear to convey signals that activate SRD neurons. 7. The findings also suggest that lamina I nociceptive specific neurons, the axons of which travel within the dorsolateral funiculus, do not contribute very much to the activation of SRD neurons.

Responses of Medullary Dorsal Horn Neurons to Corneal Stimulation by CO2 Pulses in the Rat

1999 ◽  
Vol 82 (5) ◽  
pp. 2092-2107 ◽  
Author(s):  
Harumitsu Hirata ◽  
James W. Hu ◽  
David A. Bereiter
Keyword(s):  
Thalamic Nucleus ◽  
Receptive Fields ◽  
Male Rats ◽  
Cervical Cord ◽  
Type I ◽  
Type Ii ◽  
Upper Cervical ◽  
The Difference ◽  
Evoked Activity ◽  
Stimulation Of

Corneal-responsive neurons were recorded extracellularly in two regions of the spinal trigeminal nucleus, subnucleus interpolaris/caudalis (Vi/Vc) and subnucleus caudalis/upper cervical cord (Vc/C1) transition regions, from methohexital-anesthetized male rats. Thirty-nine Vi/Vc and 26 Vc/C1 neurons that responded to mechanical and electrical stimulation of the cornea were examined for convergent cutaneous receptive fields, responses to natural stimulation of the corneal surface by CO2 pulses (0, 30, 60, 80, and 95%), effects of morphine, and projections to the contralateral thalamus. Forty-six percent of mechanically sensitive Vi/Vc neurons and 58% of Vc/C1 neurons were excited by CO2 stimulation. The evoked activity of most cells occurred at 60% CO2 after a delay of 7–22 s. At the Vi/Vc transition three response patterns were seen. Type I cells ( n = 11) displayed an increase in activity with increasing CO2 concentration. Type II cells ( n = 7) displayed a biphasic response, an initial inhibition followed by excitation in which the magnitude of the excitatory phase was dependent on CO2 concentration. A third category of Vi/Vc cells (type III, n = 3) responded to CO2 pulses only after morphine administration (>1.0 mg/kg). At the Vc/C1 transition, all CO2-responsive cells ( n = 15) displayed an increase in firing rates with greater CO2 concentration, similar to the pattern of type I Vi/Vc cells. Comparisons of the effects of CO2 pulses on Vi/Vc type I units, Vi/Vc type II units, and Vc/C1 corneal units revealed no significant differences in threshold intensity, stimulus encoding, or latency to sustained firing. Morphine (0.5–3.5 mg/kg iv) enhanced the CO2-evoked activity of 50% of Vi/Vc neurons tested, whereas all Vc/C1 cells were inhibited in a dose-dependent, naloxone-reversible manner. Stimulation of the contralateral posterior thalamic nucleus antidromically activated 37% of Vc/C1 corneal units; however, no effective sites were found within the ventral posteromedial thalamic nucleus or nucleus submedius. None of the Vi/Vc corneal units tested were antidromically activated from sites within these thalamic regions. Corneal-responsive neurons in the Vi/Vc and Vc/C1 regions likely serve different functions in ocular nociception, a conclusion reflected more by the difference in sensitivity to analgesic drugs and efferent projection targets than by the CO2 stimulus intensity encoding functions. Collectively, the properties of Vc/C1 corneal neurons were consistent with a role in the sensory-discriminative aspects of ocular pain due to chemical irritation. The unique and heterogeneous properties of Vi/Vc corneal neurons suggested involvement in more specialized ocular functions such as reflex control of tear formation or eye blinks or recruitment of antinociceptive control pathways.

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