scholarly journals A Cadaver Study Confirming the Location of Dye after Trigeminal Ganglion Rhizotomy

2021 ◽  
pp. E341-E348
Author(s):  
JiHee Hong
Keyword(s):  
Electrical Stimulation ◽  
Trigeminal Neuralgia ◽  
Trigeminal Ganglion ◽  
Anatomical Study ◽  
Cadaver Study ◽  
Trigeminal System ◽  
Therapeutic Procedure ◽  
Microscopic Evaluation ◽  
Trigeminal Root ◽  
Study Setting

Background: Radiofrequency thermal rhizotomy demonstrates an excellent treatment outcome with a high success rate among patients of intractable trigeminal neuralgia. The triangular plexus which is an immediate retrogasserian portion of the trigeminal root is suggested as the best place of lesioning during radiofrequency thermal rhizotomy. However, the anatomy of the triangular plexus has been relatively unrecognized, while the anatomical study related to therapeutic procedure is scarce. Objective: The purpose of this study is to confirm with gross and microscopic finding of the trigeminal system whether, if an electrode tip is placed on the petroclival junction in lateral cranial view, it actually arrives at the triangular plexus or not. In relation to therapeutic procedure, we examined the triangular plexus with morphological and histological methods. Study Design: Human cadaveric study. Setting: An anatomical laboratory in South Korea. Methods: Percutaneous procedure of radiofrequency thermal rhizotomy under C-arm guidance was performed in 8 cadavers. Final target of the electrode tip was the petroclival junction under true lateral cranial view. The location of the electrode tip was determined under observation of the presence of an injected dye. Triangular plexus size was measured grossly and microscopically. Gross and microscopic evaluation of the triangular plexus was performed. Results: Among 15 trigeminal systems, 8 showed dye appearance in the triangular plexus, while 6 showed it in the trigeminal ganglion. Overall, 53% of radiofrequency thermal rhizotomy could reach the triangular plexus when an electrode tip was placed on the petroclival junction. The grossly measured average triangular plexus vertical and transverse diameters were 0.8 cm and 1.3 cm, respectively. Limitation: Only radiologic landmark was used to confirm the location of the electrode tip. However, further study confirming the location of the electrode tip under the guidance of electrical stimulation is needed. Conclusion: When an electrode tip was placed on the petroclival junction, 53% of radiofrequency thermal rhizotomy could reach the triangular plexus. Key words: Petroclival junction, trigeminal neuralgia, triangular plexus, radiofrequency thermal rhizotomy

Experimental Migraine Models and Their Relevance in Migraine Therapy

Cephalalgia ◽  
2006 ◽  
Vol 26 (6) ◽  
pp. 642-659 ◽  
Author(s):  
U Arulmani ◽  
S Gupta ◽  
A Maassen VanDenBrink ◽  
D Centurión ◽  
CM Villalón ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Trigeminal Ganglion ◽  
In Vitro Models ◽  
In Vivo Model ◽  
Trigeminal System ◽  
Sagittal Sinus ◽  
Migraine Pathophysiology ◽  
Stimulation Of

Although the understanding of migraine pathophysiology is incomplete, it is now well accepted that this neurovascular syndrome is mainly due to a cranial vasodilation with activation of the trigeminal system. Several experimental migraine models, based on vascular and neuronal involvement, have been developed. Obviously, the migraine models do not entail all facets of this clinically heterogeneous disorder, but their contribution at several levels (molecular, in vitro, in vivo) has been crucial in the development of novel antimigraine drugs and in the understanding of migraine pathophysiology. One important vascular in vivo model, based on an assumption that migraine headache involves cranial vasodilation, determines porcine arteriovenous anastomotic blood flow. Other models utilize electrical stimulation of the trigeminal ganglion/nerve to study neurogenic dural inflammation, while the superior sagittal sinus stimulation model takes into account the transmission of trigeminal nociceptive input in the brainstem. More recently, the introduction of integrated models, namely electrical stimulation of the trigeminal ganglion or systemic administration of capsaicin, allows studying the activation of the trigeminal system and its effect on the cranial vasculature. Studies using in vitro models have contributed enormously during the preclinical stage to characterizing the receptors in cranial blood vessels and to studying the effects of several putative antimigraine agents. The aforementioned migraine models have advantages as well as some limitations. The present review is devoted to discussing various migraine models and their relevance to antimigraine therapy.

Microvascular Relations of the Trigeminal Nerve: An Anatomical Study

Neurosurgery ◽  
1986 ◽  
Vol 19 (4) ◽  
pp. 535-539 ◽  
Author(s):  
Boris Klun ◽  
Borut Prestor
Keyword(s):  
Trigeminal Neuralgia ◽  
Anatomical Study ◽  
Superior Cerebellar Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Marked Contrast ◽  
Entry Zone ◽  
Root Entry Zone ◽  
Cerebellar Artery ◽  
History Of ◽  
Trigeminal Root

Abstract The neurovascular relationships in the trigeminal root entry zone were studied in 130 trigeminal root entry zones of 65 cadavers. No history of facial or trigeminal pain had been obtained during life in these subjects. The technique of intravascular injection, which allowed good visualization and evaluation of the neurovascular relationships, is described. A total of 42 examples of contact with the root entry zone and 10 examples of compression were identified. In 30 of the examples of contact, the finding could be related to an artery; in the other examples, it appeared to be due to veins. Of the arterial compressions, the superior cerebellar artery was responsible in 53.8%, the anterior inferior cerebellar artery was responsible in 25.6%, and pontine branches of the basilar artery were responsible for the remaining 20.6%. Only one instance of unequivocal compression by a vein was found. Other anatomical observations of interest are reported. The absence of a history of trigeminal neuralgia in the 7% of examined nerves in which root entry zone showed arterial compression is in marked contrast to the finding of 80% or more in the operative series for trigeminal neuralgia. It seems that vascular compressions may be the predominant but not the sole cause of trigeminal neuralgia.

Transmission electron microscopic study of large myelinated fiber injury from percutaneous trigeminal ganglion compression for trigeminal neuralgia in a rabbit model

1991 ◽  
Vol 49 ◽  
pp. 88-89
Author(s):  
B.F. Hoeflinger ◽  
W.T. Gunning ◽  
J.A. Brown ◽  
A. Eckhardt ◽  
M. McDaniel ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Ganglion ◽  
Rabbit Model ◽  
Nerve Fibers ◽  
Trigeminal System ◽  
Myelinated Fiber ◽  
Electron Microscopic ◽  
Axon Terminals ◽  
C Fibers ◽  
Ganglion Neurons

Trigeminal neuralgia (TN) is a disorder characterized by paroxysmal, lancing facial pain confined to the distribution of trigeminal nerve fibers. A procedure to relieve this sensation, Percutaneous Trigeminal Ganglion Compression(PTGC), was introduced in 1983 and has been shown in clinical studies to be an effective treatment for TN. The effect of PTGC on the trigeminal system has not been adequately studied. In a previous study. New Zealand White rabbits were utilized in an attempt to evaluate the consequences of PTGC at the light microscopic level. This investigation revealed a differential demyelination and fragmentation of axons in the trigeminal(V) sensory root while trigeminal ganglion neurons were found to be preserved. Immunocytochemical stains of the spinal trigeminal tract showed no specific loss of fine caliber Ad and C-fibers. Degeneration of axon terminals was found in the deeper layers of the spinal trigeminal nucleus, the region corresponding to the termination of large myelinated axons suggesting a differential loss of these specific fibers.

scholarly journals A CACNA1A variant associated with trigeminal neuralgia alters the gating of Cav2.1 channels

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Eder Gambeta ◽  
Maria A. Gandini ◽  
Ivana A. Souza ◽  
Laurent Ferron ◽  
Gerald W. Zamponi
Keyword(s):  
Trigeminal Neuralgia ◽  
Missense Mutation ◽  
Neurotransmitter Release ◽  
Trigeminal System ◽  
Wild Type ◽  
Calcium Dependent ◽  
Whole Cell Patch Clamp ◽  
C Terminus ◽  
Dependent Inactivation

AbstractA novel missense mutation in the CACNA1A gene that encodes the pore forming α1 subunit of the CaV2.1 voltage-gated calcium channel was identified in a patient with trigeminal neuralgia. This mutation leads to a substitution of proline 2455 by histidine (P2455H) in the distal C-terminus region of the channel. Due to the well characterized role of this channel in neurotransmitter release, our aim was to characterize the biophysical properties of the P2455H variant in heterologously expressed CaV2.1 channels. Whole-cell patch clamp recordings of wild type and mutant CaV2.1 channels expressed in tsA-201 cells reveal that the mutation mediates a depolarizing shift in the voltage-dependence of activation and inactivation. Moreover, the P2455H mutant strongly reduced calcium-dependent inactivation of the channel that is consistent with an overall gain of function. Hence, the P2455H CaV2.1 missense mutation alters the gating properties of the channel, suggesting that associated changes in CaV2.1-dependent synaptic communication in the trigeminal system may contribute to the development of trigeminal neuralgia.

Attempts to Suppress Tinnitus with Transcutaneous Electrical Stimulation

1985 ◽  
Vol 93 (3) ◽  
pp. 385-389 ◽  
Author(s):  
Jack A. Vernon ◽  
James A. Fenwick
Keyword(s):  
Electrical Stimulation ◽  
Positive Response ◽  
Transcutaneous Electrical Stimulation ◽  
Therapeutic Procedure ◽  
Placebo Trial ◽  
Electrical Stimuli ◽  
Severe Tinnitus

Various electrical stimuli were tested for their ability to suppress or relieve severe tinnitus. Stimulation was applied transdermally by electrodes placed on the preauricular and postauricular regions and on the two mastoids. Of the 50 patients tested, only 14 (28%) obtained relief that met the criterion of a reduction in the tinnitus by 40% or more. When relief was obtained, it usually extended for several hours into the poststimulation period. There was only one positive response (2%) In the placebo trial, which was administered to all patients. It was concluded that transdermal electrical stimulation such as that used in this research Is not a practical therapeutic procedure for the relief of tinnitus.

Pathophysiology of trigeminal neuralgia: new evidence from a trigeminal ganglion intraoperative microneurographic recording

2004 ◽  
Vol 101 (5) ◽  
pp. 872-873 ◽  
Author(s):  
Kim J. Burchiel ◽  
Thomas K. Baumann
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Ganglion ◽  
Physiological Mechanism ◽  
Vascular Compression ◽  
Entry Zone ◽  
Content Type ◽  
Root Entry Zone ◽  
Trigeminal Ganglion Neurons ◽  
Ganglion Neurons ◽  
New Evidence

✓ The origin of trigeminal neuralgia (TN) appears to be vascular compression of the trigeminal nerve at the root entry zone; however, the physiological mechanism of this disorder remains uncertain. The authors obtained intraoperative microneurographic recordings from trigeminal ganglion neurons in a patient with TN immediately before percutaneous radiofrequency-induced gangliolysis. Their findings are consistent with the idea that the pain of TN is generated, at least in part, by an abnormal discharge within the peripheral nervous system.

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