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cranials neuralgias

Loraine Van Slyke, Mia Scott
HIV pre-exposure prophylaxis (PrEP) with emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF) fixed-dose combination (FTC/TDF) is undergoing rapid scale-up in the United States. While FTC/TDF is typically well tolerated, to our knowledge, cranial nerve pathology associated with FTC/TDF has not been previously described. We report the case of a 35-year-old patient who began FTC/TDF PrEP and developed acute trigeminal neuralgia. The neurologic symptoms resolved after treatment discontinuation and recurred upon rechallenge, resulting in permanent discontinuation of PrEP treatment...
January 2018: Journal of the International Association of Providers of AIDS Care
Marc Vecchi, Ricardo Pereira Mestre, S Luciamma Thiekalamuriyil, Roberto Cartolari
In the context of painful cranial neuropathies, a very rare cause is represented by the irritation of the glossopharyngeal nerve due to various aetiologic factors. Here, we present a case of neuralgia of the ninth right cranial nerve due to a compression of its nerve root upon the kinking of the homolateral vertebral artery, resulting in a disabling clinical overview for the patient. Our objective was to focus the reader's attention on the clinical manifestation, which alone could lead to an immediate diagnosis...
September 2017: Case Reports in Neurology
Jehad Zakaria, Michael Wemhoff, Douglas Anderson
Vascular compression of neural structures has long been established as an etiology for dysfunction of multiple cranial nerves. Classically, as is the case of trigeminal neuralgia, vascular compression by an offending artery and sometimes vein exerting pressure at the root entry zone of the trigeminal nerve can lead to the characteristic pain syndrome. In these cases, microvascular decompression is an effective, durable surgical intervention to relieve the neuralgia. In this report, we present a unique case of a patient with direct compression of the medulla oblongata by an arachnoid cyst and associated vascular loops, with subsequent resolution of the patient's symptoms following fenestration of cyst and microvascular decompression...
February 24, 2018: World Neurosurgery
Joanna M Zakrzewska, Ning Wu, John Y K Lee, Brian Werneburg, Deborah Hoffman, Ying Liu
BACKGROUND AND AIM: Trigeminal neuralgia (TN) is a rare orofacial disorder characterized by severe unilateral paroxysmal pain in the region of the fifth cranial nerve. Clinical guidelines recommend carbamazepine (only US Food and Drug Administration-approved drug for TN) and oxcarbazepine as first-line therapies. We utilized the US Truven Health MarketScan database to examine treatment patterns among patients with TN. METHODS: Included patients were aged ≥18 years, newly diagnosed with TN (≥2 TN diagnoses ≥14 days apart; no diagnosis in the prior year), continuously enrolled 1 year pre-index, with ≥3 years' follow-up post-index...
February 19, 2018: Clinical Journal of Pain
Thien Nguyen, Courtney Duong, John P Sheppard, Seung Jin Lee, Amar U Kishan, Percy Lee, Stephen Tenn, Robert Chin, Tania B Kaprealian, Isaac Yang
Vestibular schwannomas (VS) are benign tumors stemming from the eighth cranial nerve. Treatment options for VS include conservative management, microsurgery, stereotactic radiosurgery, and fractionated radiotherapy. Though microsurgery has been the standard of care for larger lesions, hypo-fractionated stereotactic radiotherapy (hypo-FSRT) is an emerging modality. However, its clinical efficacy and safety have yet to be established. We conducted a systematic review and meta-analysis of manuscripts indexed in PubMed, Scopus, Web of Science, Embase, and Cochrane databases reporting outcomes of VS cases treated with hypo-FSRT...
March 2018: Clinical Neurology and Neurosurgery
Cheng-Chia Lee, Shin Tai Chong, Ching-Jen Chen, Sheng-Che Hung, Huai-Che Yang, Chung-Jung Lin, Chih-Chun Wu, Wen-Yuh Chung, Wan-Yuo Guo, David Hung-Chi Pan, Hsiu-Mei Wu, Jason P Sheehan, Ching-Po Lin
BACKGROUND: Diffusion tensor imaging (DTI) is a novel MRI technique that enables noninvasive evaluation of microstructural alterations in white matter of brain. Initially, DTI was used in intra- or inter-hemispheric association bundles. Recent technical advances are overcoming the challenges of imaging small white matter bundles, such as the cranial nerves. In this study, we use DTI to shed more light on the microstructure changes in long-standing trigeminal neuralgia. We also utilize DTI to study the effect of early stereotactic radiosurgery (SRS) on the microstructures of the trigeminal nerve and to predict the effectiveness of early SRS in the treatment of medically refractory trigeminal neuralgia (TN)...
February 3, 2018: Acta Neurochirurgica
Zjiwar H A Sadik, Suan Te Lie, Sieger Leenstra, Patrick E J Hanssens
OBJECTIVE Petroclival meningiomas (PCMs) can cause devastating clinical symptoms due to mass effect on cranial nerves (CNs); thus, patients harboring these tumors need treatment. Many neurosurgeons advocate for microsurgery because removal of the tumor can provide relief or result in symptom disappearance. Gamma Knife radiosurgery (GKRS) is often an alternative for surgery because it can cause tumor shrinkage with improvement of symptoms. This study evaluates qualitative volumetric changes of PCM after primary GKRS and its impact on clinical symptoms...
January 26, 2018: Journal of Neurosurgery
Randy C Bowen, Jan N Koeppel, Chance D Christensen, Karisa B Snow, Junjie Ma, Bradley J Katz, Howard R Krauss, Klara Landau, Judith E A Warner, Alison V Crum, Dominik Straumann, Kathleen B Digre
BACKGROUND: Eye pain is a common complaint, but no previous studies have determined the most common causes of this presenting symptom. Our objective was to determine the most common causes of eye pain in 2 ophthalmology and neurology departments at academic medical centers. METHODS: This was a retrospective cross-sectional analysis and chart review at the departments of ophthalmology and neurology at the University Hospital Zurich (USZ), University of Zürich, Switzerland, and the University of Utah (UU), USA...
January 12, 2018: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Hyeong Cheol Moon, Soon-Tae You, Hyeon Man Baek, Young Jai Jeon, Chan-A Park, Jei Jun Cheong, Youn Joo Lee, Young Seok Park
7.0Tesla(T) high-resolution diffusion tensor imaging (DTI) can supply information on changing microstructures in cranial nerves. We investigated DTI parameters and the feasibility of DTI criteria for diagnosing trigeminal neuralgia (TN). In this study, 14 patients (28 hemispheres) of mean age 49.0years (range, 31-64) with TN underwent DTI using 7.0TMRI. We compared fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD) of affected-side and unaffected-side trigeminal nerves using DTI...
January 2, 2018: Magnetic Resonance Imaging
Eric Goulin Lippi Fernandes, Sander de Ru, Kai Miller, Kuo Sen Han
BACKGROUND: Intermediate nerve neuralgia (INN) is a rare and often overlooked form of primary otalgia. The pathophysiological mechanism is unknown, although one of the possible contributing factors is a neurovascular conflict at the root entry zone of the intermediate nerve. The pain can be severely debilitating, and the palette of treatment options is small. OBJECTIVE: To assess the outcome of microvascular decompression (MVD) of the VII/VIII cranial nerve complex for treating INN...
December 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
Toshiki Fukuoka, Yusuke Nishimura, Masahito Hara, Kei Nomura, Hiroshi Ryu, Satoshi Yoshikawa, Toshihiko Wakabayashi
OBJECTIVE: The aim of this study was to investigate prognostic factors for microvascular decompression (MVD) in patients with primary trigeminal neuralgia (TN), with a particular focus on the morphology of the posterior cranial fossa (PCF). METHODS: The present study investigated 126 surgically treated primary TN patients with more than 1-year follow-up who underwent high-resolution magnetic resonance imaging between April 2003 and September 2015. We retrospectively reviewed clinical information and operative findings...
December 27, 2017: World Neurosurgery
Aynur Özge, Ishaq Abu-Arafeh, Amy A Gelfand, Peter James Goadsby, Jean Christophe Cuvellier, Massimiliano Valeriani, Alexey Sergeev, Karen Barlow, Derya Uludüz, Osman Özgür Yalın, Noemi Faedda, Richard B Lipton, Alan Rapoport, Vincenzo Guidetti
BACKGROUND: The 2013 International Classification of Headache Disorders-3 was published in a beta version to allow clinicians to confirm the validity of the criteria or suggest improvements based on field studies. The aim of this work was to review the Secondary Headache Disorders and Cranial Neuralgias and Other Headache Disorders sections of ICHD-3 beta data on children and adolescents (age 0-18 years) and to suggest changes, additions, and amendments. METHODS: Several experts in childhood headache across the world applied different aspects of ICHD-3 beta in their normal clinical practice...
November 29, 2017: Journal of Headache and Pain
Arkady Kotlyar
Background: Trigeminal neuralgia (TN) is the most common cranial neuralgia in adults, with a slightly higher incidence in women than in men. This chronic pain condition affects the trigeminal nerve, also known as the 5th cranial nerve. It is one of the most deeply distributed nerves in the head. Antiseizure drugs are the main biomedical treatment of TN. However, TN is not the only source of facial pain. Background persistent idiopathic facial pain (PIFP) is also a chronic disorder, recurring daily for more than 2 hours per day over more than 3 months...
December 1, 2017: Medical Acupuncture
Valentina Simioni, J G Capone, E Sette, E Granieri, M Farneti, M A Cavallo, V Tugnoli
Intraoperative monitoring during cerebellopontine angle surgery is widely accepted. While techniques which monitor cranial motor nerves are commonly used, monitoring the sensory afferents has been challenging. Considering the reflex arc, blink reflex (BR) might be useful in monitoring the sensory part of the trigeminal nerve, the brainstem connections and the facial nerve. We describe the case of a patient who developed hemifacial hypoesthesia after microvascular decompression surgery for trigeminal neuralgia...
January 2018: Acta Neurochirurgica
Mrityunjoy Sarkar, Ashok Pillai
BACKGROUND AND IMPORTANCE: The lateral suboccipital approach for microvascular decompression (MVD) of the trigeminal nerve has become a standard-of-care over the past several decades. Syndromic cranial base settling, a rare but known cause for trigeminal neuralgia (TN), poses significant dilemmas in clinical management. In such cases, distorted anatomy may render surgery via the suboccipital approach difficult or even impossible. CLINICAL PRESENTATION: A 34-yr-old male with osteogenesis imperfecta and severe basilar invagination suffered from TN that was refractory to medication and stereotactic radiosurgery...
November 18, 2017: Operative Neurosurgery (Hagerstown, Md.)
Jong Min Lee, Kum Whang, Sung Min Cho, Jong Yeon Kim, Ji Woong Oh, Youn Moo Koo, Chul Hu, Jinsoo Pyen, Jong Wook Choi
The Onyx liquid embolic system is a relatively safe and commonly used treatment for vascular malformations, such as arteriovenous fistulas and arteriovenous malformations. However, studies on possible complications after Onyx embolization in patients with vascular malformations are limited, and the occurrence of cranial nerve palsy is occasionally reported. Here we report the progress of two different types of cranial nerve palsy that can occur after embolization. In both cases, Onyx embolization was performed to treat vascular malformations and ipsilateral oculomotor and facial nerve palsies were observed...
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
Lal Rehman, Iram Bokhari, Shamim Ul Siddiqi, Veejay Bagga, Muhammad Masood Hussain
BACKGROUND: The clinical outcome following surgical resection of intracranial epidermoid lesions is not well documented. We describe a case series evaluating the clinical presentation and outcome following surgery in patients diagnosed with these lesions. MATERIALS AND METHODS: A retrospective study conducted over a 4-year period. RESULTS: A total 38 patients who underwent surgery for intracranial epidermoid lesions were identified. Of these, 20 were supertentorial and 18 were infratentorial lesions...
October 2, 2017: Turkish Neurosurgery
Florian Bernard, Philippe Mercier, Marc Sindou
Vago-glossopharyngeal neuralgia (VGPN) is a rarely seen disease when compared to trigeminal neuralgia. When the pain is resistant to medical therapy, microvascular decompression can be performed if a vascular conflict is suspected on magnetic resonance imaging (MRI). In addition, arachnoid pathology may play a role in VGPN. We report two cases of VGPN caused by tethered arachnoid, associated with a vascular contact in which pain was reduced by freeing rootlets from arachnoid compression. We report two cases relating to 50-year-old and 30-year-old men with a history of electric shooting pain triggered by swallowing in the right pharyngeal and auricular regions...
January 2018: Acta Neurochirurgica
Murat Alemdar
Dolichoectesia is described as elongation, widening, and tortuosity of an artery. Most commonly involved vessels are the intracranial vertebral and basilar arteries. Vertebrobasilar artery dolichoectesia is usually asymptomatic. Cerebral ischemia, hemorrhage, or compression findings due to mass effect can be seen in symptomatic patients. Although there are case reports of trigeminal neuralgia due to fifth cranial nerve compression in the literature, to the best of our knowledge, neither hemicranial nor continuous facial pain secondary to vertebrobasilar artery dolichoectesia has been reported previously...
July 2017: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Mehmet Tecellioglu, Suat Kamisli, Mehmet Fatih Erbay, Ozden Kamisli, Cemal Ozcan
INTRODUCTION: Varicella Zoster Virus (VZV) is associated with many disorders of the central and peripheral nervous systems including neuralgia, meningitis, meningoencephalitis, cerebellitis, vasculopathy, myelopathy, Ramsay-Hunt syndrome, and polyneuritis cranialis. Cranial nerves V, VI, VII, VIII, IX, X, XI, and/or XII may be affected. The neurological disorders caused by VZV usually present with rash, but may rarely present without rash. CASE REPORT: We herein present a case of polyneuritis cranialis without rash caused by VZV affecting cranial nerves VII, VIII, IX, and X...
August 2017: Medical Archives
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