scholarly journals Clinical and Radiological Profile of Trigeminal Neuralgia- A Retrospective Study

2020 ◽  
Author(s):  
Roy Thomas
Keyword(s):  
Trigeminal Neuralgia ◽  
Clinical Features ◽  
Trigeminal Nerve ◽  
Dental Treatment ◽  
Pain Severity ◽  
Categorical Variables ◽  
Imaging Features ◽  
Trigger Factors ◽  
Maxillary Nerve ◽  
Lancinating Pain

Introduction: Trigeminal neuralgia is described as severe, stabbing unilateral pain along the distribution of trigeminal nerve branches. The three subtypes include- Classical, secondary and idiopathic. Aim: To study the clinical profile, presentation and radiological imaging features in trigeminal neuralgia patients. Materials and Methods: This cross-sectional study included outpatient medical records of 60 trigeminal neuralgia patients between June 2015 to June 2020 (five years) in a Tertiary care Medical College Hospital. Various parameters studied were: (a) Age; (b) Gender; (c) Dental treatment; (d) Pain severity; (e) Trigger factors; (f) Side and branch involved; (g) Sensory abnormalities; (h) MRI. Data was entered in Microsoft excel and analysed using SPSS statistical software 20.0. Chi-square test was used for categorical variables. Results: Among the 60 patients studied, the common demographic and clinical features were as follows: 34 were females (56.7%); 36 with right side presentation (60%); 25 had maxillary nerve division distribution (41.7%); 57 patients experienced shock/lancinating pain (95%); and 40 had numeric pain severity scale of 4-6 (66.7%). Classical Trigeminal Neuralgia was the most common subtype seen in 31 patients (51.7%). Involvement of dual divisions (maxillary and mandibular), absence of trigger factors and presence of hypoesthesia were more suggestive of Secondary Trigeminal Neuralgia (p<0.05). Based on MRI imaging, 31 (51.7%) showed neurovascular compression with atrophy or displacement of trigeminal nerve root. Only 5 (8.4%) had secondary causes (schwannoma, meningioma, demyelination, infarct). Conclusion: The key clinical features of trigeminal neuralgia include female preponderance, right side presentation, maxillary nerve division distribution, shock/lancinating pain with touch and breeze as common trigger factors. As some of them had a previous dental treatment or procedure, dentists need to be aware of this entity. Certain clinical features would help to differentiate the secondary from classic and idiopathic neuralgia subtype.

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.

scholarly journals Efficacy of primary microvascular decompression versus subsequent microvascular decompression for trigeminal neuralgia

2017 ◽  
Vol 126 (5) ◽  
pp. 1691-1697 ◽  
Author(s):  
Debebe Theodros ◽  
C. Rory Goodwin ◽  
Matthew T. Bender ◽  
Xin Zhou ◽  
Tomas Garzon-Muvdi ◽  
...  
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Microvascular Decompression ◽  
Pain Control ◽  
Surgical Intervention ◽  
Patient Records ◽  
Duration Of Symptoms ◽  
Facial Numbness ◽  
Lancinating Pain

OBJECTIVETrigeminal neuralgia (TN) is characterized by intermittent, paroxysmal, and lancinating pain along the distribution of the trigeminal nerve. Microvascular decompression (MVD) directly addresses compression of the trigeminal nerve. The purpose of this study was to determine whether patients undergoing MVD as their first surgical intervention experience greater pain control than patients who undergo subsequent MVD.METHODSA retrospective review of patient records from 1998 to 2015 identified a total of 942 patients with TN and 500 patients who underwent MVD. After excluding several cases, 306 patients underwent MVD as their first surgical intervention and 175 patients underwent subsequent MVD. Demographics and clinicopathological data and outcomes were obtained for analysis.RESULTSIn patients who underwent subsequent MVD, surgical intervention was performed at an older age (55.22 vs 49.98 years old, p < 0.0001) and the duration of symptoms was greater (7.22 vs 4.45 years, p < 0.0001) than for patients in whom MVD was their first surgical intervention. Patients who underwent initial MVD had improved pain relief and no improvement in pain rates compared with those who had subsequent MVD (95.8% and 4.2% vs 90.3% and 9.7%, respectively, p = 0.0041). Patients who underwent initial MVD had significantly lower rates of facial numbness in the pre- and postoperative periods compared with patients who underwent subsequent MVD (p < 0.0001). The number of complications in both groups was similar (p = 0.4572).CONCLUSIONSThe results demonstrate that patients who underwent other procedures prior to MVD had less pain relief and a higher incidence of facial numbness despite rates of complications similar to patients who underwent MVD as their first surgical intervention.

scholarly journals Diplopia following Extraoral Maxillary Nerve Blockade for Trigeminal Neuralgia

2018 ◽  
Vol 05 (03) ◽  
pp. 193-194
Author(s):  
Siddharth Chavali ◽  
Girija P. Rath ◽  
Parmod K. Bithal
Keyword(s):  
Trigeminal Neuralgia ◽  
Nerve Block ◽  
Trigeminal Nerve ◽  
Nerve Stimulation ◽  
Abducens Nerve ◽  
Injection Technique ◽  
Nerve Blockade ◽  
Maxillary Nerve ◽  
Management Protocol ◽  
Tip Position

AbstractWe report a case of diplopia due to reversible abducens nerve block associated with extraoral maxillary blockade of the trigeminal nerve. This complication occurs despite precautions such as aspiration and confirmation of needle tip position with nerve stimulation. Knowledge of this condition and its potential cause should alert the physician to the importance of appropriate injection technique and an understanding of the management protocol.

Trigeminal Neuralgia: Role of Interventional Pain Physician

2019 ◽  
Vol 11 (1) ◽  
pp. 73-77
Author(s):  
Chandra Shekhar Karmakar ◽  
Md Lutfor Rahman ◽  
Md Shahidul Islam ◽  
Atidh Muhammad Molla ◽  
Monirul Islam ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Treatment Options ◽  
Vascular Compression ◽  
Gasserian Ganglion ◽  
Invasive Treatment ◽  
Provide Pain Relief ◽  
Lancinating Pain ◽  
Glycerol Rhizolysis ◽  
Neural Discharge

Trigeminal neuralgia (TN) or tic douloureux is one of the commonest cause of fascial pain after 50 years of age. It is characterized by recurrent, episodic, lancinating pain over the distribution of trigeminal nerve. There is a lack of certainty regarding the aetiology and pathophysiology of TN. Evidence suggests that the likely etiology is vascular compression of the trigeminal nerve leading to focal demyelination and aberrant neural discharge. Secondary causes such as multiple sclerosis or brain tumors can also produce symptomatic TN. The treatment of TN can be very challenging despite the numerous options patients and physicians can choose from. This multitude of treatment options poses the question as to which treatment fits which patient best. For patients refractory to medical therapy, Gasserian ganglion percutaneous techniques, gamma knife surgery and microvascular decompression are the most promising invasive treatment options. Among them three common interventions commonly carried out by interventional pain physician to provide pain relief are balloon compression, Glycerol rhizolysis and RF rhizotomy. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 73-77

Chronic Paroxysmal Hemicrania-Tic Syndrome

Cephalalgia ◽  
1998 ◽  
Vol 18 (3) ◽  
pp. 159-161 ◽  
Author(s):  
AB Caminero ◽  
JA Pareja ◽  
JL Dobato
Keyword(s):  
Trigeminal Neuralgia ◽  
Female Patient ◽  
Clinical Features ◽  
Trigeminal Nerve ◽  
Paroxysmal Hemicrania ◽  
Tic Douloureux ◽  
Chronic Paroxysmal Hemicrania ◽  
Orbital Region

We report the coexistence of both chronic paroxysmal hemicrania (CPH) and trigeminal neuralgia (tic douloureux) in a female patient. The clinical features combined to make a configuration of CPH-tic syndrome. The two components of the syndrome appeared synchronously in the same orbital region—first branch of the trigeminal nerve—with a latency of several years after the onset of isolated tic attacks of the second and third trigeminal divisions. The concurrence of both types of pain in the same symptomatic area may have some significance for pathogenic, clinical, and pharmacological aspects of such a syndrome. We discuss all these and postulate a provisional distinction between CPH-V2,3 tic and CPH-V1 tic.

scholarly journals Refractory Trigeminal Neuralgia: Successful Treatment with LINAC Based Stereotactic Radiosurgery (SRS): First Case in Bangladesh

2020 ◽  
Vol 10 (1) ◽  
pp. 123-129
Author(s):  
Taohida Yasmin ◽  
Narendra Kumar ◽  
Sandip K Das ◽  
Murugan Appasamy ◽  
KM Masud Rana ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Pain Control ◽  
Pain Syndrome ◽  
Safe Procedure ◽  
Non Invasive ◽  
First Case ◽  
The Face ◽  
Lancinating Pain

Purpose: To present first case of refractory trigeminal Neuralgia treated with SRS in Bangladesh, procedural technique, and outcomes in terms of pain relief. Background: Trigeminal neuralgia (TN), classically known as tic doloureaux is a chronic and recurrent disabling pain syndrome, which described as episodes of lancinating pain over the face along the sensory distribution of trigeminal nerve. First line management of TN is medical with different permutation & combination to control the pain. After the failure of medical management, non-invasive SRS is an established modality to achieve long term pain control. Here, we are reporting a case of TN treated with LINAC based SRS. Case Presentation: A 61 years old, gentleman who developed piercing pain inside his left eye for a duration 1-1.5 sec, precipitated while shaving, brushing teeth in year 2015, occurred 4-5 time a day. He was diagnosed as left TN of V1, started on Carbamazepine, Pregabalin. In 3 years, pain progressed to involve all 3 branches. Even combination Carbamazepine, Gabapentin, Tramadol, Amitriptyline, Clonazepam, & Morphine could not control the pain. Pain was persisting all over the day and he also developed suicidal tendency. Later he has been referred to us for SRS. SRS was done in April-2019, a dose of 90Gy was delivered to the Distal Retrogasserian (RG) also called Marseille point of trigeminal nerve root. Eight months after the SRS patient is almost free of pain without any Medicine. Conclusions: LINAC based SRS is a non-invasive, frameless, and safe procedure with excellent pain control for refractory Trigeminal neuralgia. Bang. J Neurosurgery 2020; 10(1): 123-129

Temporal disconnection between pain relief and trigeminal nerve microstructural changes after Gamma Knife radiosurgery for trigeminal neuralgia

2020 ◽  
Vol 133 (3) ◽  
pp. 727-735
Author(s):  
Peter Shih-Ping Hung ◽  
Sarasa Tohyama ◽  
Jia Y. Zhang ◽  
Mojgan Hodaie
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Pain Intensity ◽  
Gamma Knife ◽  
Trigeminal Nerve ◽  
Diffusion Tensor ◽  
Gamma Knife Radiosurgery ◽  
Time Points ◽  
Microstructural Effect

OBJECTIVEGamma Knife radiosurgery (GKRS) is a noninvasive surgical treatment option for patients with medically refractive classic trigeminal neuralgia (TN). The long-term microstructural consequences of radiosurgery and their association with pain relief remain unclear. To better understand this topic, the authors used diffusion tensor imaging (DTI) to characterize the effects of GKRS on trigeminal nerve microstructure over multiple posttreatment time points.METHODSNinety-two sets of 3-T anatomical and diffusion-weighted MR images from 55 patients with TN treated by GKRS were divided within 6-, 12-, and 24-month posttreatment time points into responder and nonresponder subgroups (≥ 75% and < 75% reduction in posttreatment pain intensity, respectively). Within each subgroup, posttreatment pain intensity was then assessed against pretreatment levels and followed by DTI metric analyses, contrasting treated and contralateral control nerves to identify specific biomarkers of successful pain relief.RESULTSGKRS resulted in successful pain relief that was accompanied by asynchronous reductions in fractional anisotropy (FA), which maximized 24 months after treatment. While GKRS responders demonstrated significantly reduced FA within the radiosurgery target 12 and 24 months posttreatment (p < 0.05 and p < 0.01, respectively), nonresponders had statistically indistinguishable DTI metrics between nerve types at each time point.CONCLUSIONSUltimately, this study serves as the first step toward an improved understanding of the long-term microstructural effect of radiosurgery on TN. Given that FA reductions remained specific to responders and were absent in nonresponders up to 24 months posttreatment, FA changes have the potential of serving as temporally consistent biomarkers of optimal pain relief following radiosurgical treatment for classic TN.

Possibilities and prospects in early orthopaedic rehabilitation of children with ectodermal dysplasia and congenital edentulism. clinical features and practical experience

2020 ◽  
pp. 40-50
Author(s):  
V.G. Galonsky ◽  
N.V. Tarasova ◽  
E.S. Surdo ◽  
A.V. Gradoboev
Keyword(s):  
Preschool Children ◽  
Clinical Features ◽  
Ectodermal Dysplasia ◽  
Dental Treatment ◽  
Practical Experience ◽  
Dental Clinic ◽  
Pedagogical Tools ◽  
Psychological Types ◽  
Clinical Cases

The article is devoted to the issue of early orthopaedic rehabilitation of youngest preschool children with ectodermal dysplasia and congenital edentulism. The essence and details of children’s psychophysiological development at this age are revealed, as well as main pedagogical tools making it possible to adapt the children to the specific environment of the dental clinic and motivate them for undergoing long-term multistage orthopaedic dental treatment. Clinical approaches and peculiarities in the dentist’s work with children of different psychological types as well as particular aspects in their adaptation to removable dentures are described. Two clinical cases of effective orthopaedic rehabilitation of 3-years-old children with ectodermal dysplasia and congenital edentulism using full removable lamellar dentures.

Sign in / Sign up

Export Citation Format

Share Document