An Evaluation of Palliative Surgical Procedures in Trigeminal Neuralgia

1952 ◽  
Vol 9 (4) ◽  
pp. 390-394 ◽  
Author(s):  
Everett G. Grantham ◽  
Ludwig H. Segerberg
Keyword(s):  
Trigeminal Neuralgia ◽  
Surgical Procedures

scholarly journals Revisiting the Corneal and Blink Reflexes for Primary and Secondary Trigeminal Facial Pain Differentiation

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Zafar Ali Khan
Keyword(s):  
Trigeminal Neuralgia ◽  
Surgical Procedures ◽  
Facial Pain ◽  
Anatomical Location ◽  
Treatment Interventions ◽  
Significant Information ◽  
Clinical Methods ◽  
Corneal Reflex ◽  
The Central Nervous System ◽  
Peripheral Neurectomy

Trigeminal neuralgia is often misdiagnosed at initial presentation due to close connotation with dental pain and is often over diagnosed for the very same reasons leading to numerous unnecessary surgical procedures such as peripheral neurectomy and alcohol injections, while the actual cause may remain elusive for decades. Evaluation of the neurosensory system may disclose the correct anatomical location of the etiology. The neurological examination may be clouded by the sensory deficits subsequent to previous peripheral surgical procedures. The corneal and blink reflexes are integral measures of the trigeminal and facial neurosensory assessment, and their abnormal function may facilitate the identification of intrinsic disease of the brain stem. These reflexes can be employed to discover pathological lesions including intracranial space-occupying trigeminal, lateral medullary, cerebral hemispheric lesions, and degenerative diseases of the central nervous system. Dental surgeons and oral and maxillofacial surgeons should consider corneal reflex in neurological assessment of patient presenting with trigeminal neuralgia-like symptoms. Failure to evaluate corneal sensitivity may lead to delayed or inaccurate diagnosis and unsuitable or redundant treatment interventions. This simple noninvasive reflex can be performed by chair-side and may provide significant information regarding the origin of facial pain and is an invaluable part of clinical methods especially in remote and peripheral healthcare center practitioners where sophisticated radiographic investigations such as computed tomography and magnetic resonance imaging may not be available.

scholarly journals Long-Term Results after Glycerol Rhizotomy for Multiple Sclerosis-Related Trigeminal Neuralgia

1994 ◽  
Vol 21 (2) ◽  
pp. 137-140 ◽  
Author(s):  
Douglas Kondziolka ◽  
L. Dade Lunsford ◽  
David J. Bissonette
Keyword(s):  
Multiple Sclerosis ◽  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Surgical Procedures ◽  
Pain Control ◽  
Long Term Results ◽  
Sensory Loss ◽  
Single Patient

Abstract:Percutaneous retrogasserian glycerol rhizotomy (PRGR) was used during an 11-year interval in 53 patients with typical trigeminal neuralgia associated with multiple sclerosis. All patients had failed extensive medical trials prior to PRGR. Long-term (median follow-up, 36 months) complete pain relief (no further medication) was achieved in 29 (59%) of 49 evaluable patients. Eight patients (16%) had satisfactory pain control but required occasional medication. Twelve patients (25%) had initial unsatisfactory results with inadequate pain relief; nine underwent alternative surgical procedures. Sixteen patients (30%) subsequently required repeat glycerol rhizotomies to reachieve pain control. Twenty-seven patients (60% of 45 patients evaluated for this finding) retained normal trigeminal sensation after injection. Major trigeminal sensory loss developed in a single patient who had four glycerol rhizotomies over a 25-month interval. No patient developed deafferentation pain. We believe that PRGR is a low-morbidity, effective, and repeatable surgical procedure for the management of trigeminal neuralgia in the setting of multiple sclerosis.

scholarly journals RELEVANCE OF LASUNA RASAYANA IN THE MANAGEMENT OF OPHTHALMIC NEURALGIA WITH RESPECT TO VATAPARYAYA- A CASE REPORT

2021 ◽  
pp. 72-76
Author(s):  
Sreekumar K ◽  
Athulya N B
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Surgical Procedures ◽  
Trigeminal Nerve ◽  
Electric Shock ◽  
Close Similarity ◽  
Recurrent Pain ◽  
Suicidal Tendency

Trigeminal neuralgia, otherwise known as suicidal disease is the severe and recurrent pain in the distribution of one or more branches of Trigeminal nerve. Patient usually presents with sharp electric shock like pain in face or mouth which lasts for seconds to minutes. This condition may lead the patient to a stage of depression and suicidal tendency. In ophthalmic neuralgia V1 branch of trigeminal nerve is affected where the pain can be interpreted as coming from nose, eyes and head in the areas around the scalp. The management involves anticonvulsants, antidepressants and surgical procedures. Vathaparyaya described by Acharyas shows a close similarity with ophthalmic neuralgia in which vitiated Vata causes pain in the areas of eyelashes and eyebrows. The management of Vataparya is given as same as that of the Vatabhishyanda. In present study, it is observed that Ayurvedic management has provided a significant reduction in intensity and frequency of pain.

Radiosurgery for Trigeminal Neuralgia

2018 ◽  
pp. 187-215
Author(s):  
Daivik B. Vyas ◽  
Lily H. Kim ◽  
Allen Ho ◽  
Eric S. Sussman ◽  
Arjun V. Pendharkar ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Minimally Invasive ◽  
Surgical Procedures ◽  
Trigeminal Nerve ◽  
Treatment Modality ◽  
Clinical Utility ◽  
Treatment Protocol ◽  
Low Risk ◽  
Image Guided ◽  
Symptomatic Management

Trigeminal neuralgia is a debilitating neuropathic condition characterized by recurrent paroxysms of shock-like pain across the distribution of the trigeminal nerve, often brought on by innocuous stimuli. Available therapies presently include symptomatic management using anti-convulsant drugs and invasive surgical procedures to target the pathogenic drivers of disease or ablate the trigeminal nerve. Radiosurgery is a treatment modality that offers a minimally invasive, low-risk alternative that has promising clinical utility in the management of refractory trigeminal neuralgia. Radiosurgical approaches like Gamma Knife (GKS) and Cyberknife (CK) utilize image-guided, algorithm-defined dose contouring to disrupt pathogenic pain signaling by delivering targeted amounts of radiation along different points on the trigeminal nerve. This chapter reviews the structure of radiotherapy paradigms, treatment protocol, major outcomes, associated risks, relative clinical utility, and areas of further research that underlie the use of CK and GKS in managing trigeminal neuralgia.

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