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Zhi Dou, Xueyi Zhang, Liqiang Yang, Wanqian Wang, Na Li, Zhicheng Liu, Jiaxiang Ni
We used resting-state fMRI to investigate regional homogeneity (ReHo) changes in patients with TN before and after PRT procedure, and to speculate about its possible mechanisms.Thirty-one TN patients underwent the PRT procedure had MRI scans just before and 6 months after surgery. The anatomical and resting-state functional images were all acquired. Patients' visual analog scales (VAS) scores, facial numbness, and disease duration were also recorded. Voxel-wise ReHo analysis was performed to detect the altered regional clusters after surgery...
October 2016: Medicine (Baltimore)
Sanjay Prakash, Chaturbhuj Rathore
BACKGROUND: Trigeminal neuralgia (TN) has been described in association with various primary headache disorders. So far, no case of TN has been reported in association with hemicrania continua (HC). CASE REPORT: Here, we report two patients of hemicrania continua associated with TN (HC-tic syndrome). These patients had both headaches concurrently. Both patients responded to a combination of carbamazepine and indomethacin. The skipping or tapering of carbamazepine led to the recurrence of the neuralgic pain of TN...
October 18, 2016: Headache
Weihua Ding, Shuping Chen, Rong Wang, Jun Cai, Yuan Cheng, Liang Yu, Qinghua Li, Fang Deng, Shengmei Zhu, Wenhua Yu
Percutaneous radiofrequency thermocoagulation (RFT) of the Gasserian ganglion is an effective treatment for primary trigeminal neuralgia (pTN). Currently Hartel anterior approach is the most commonly used method to access the Gasserian ganglion. However, this approach is associated with high recurrence rate and technical difficulties in certain patients with foramen ovale (FO) anatomical variations. In the present study, we assessed the feasibility of accessing the Gasserian ganglion through the FO from a mandibular angle under computed tomography (CT) and neuronavigation guidance...
October 2016: Medicine (Baltimore)
Bhagya Ranjan Jena, Anil Paswan, Yashpal Singh, Sandeep Loha, Anil Prasad Singh, Virendra Rastogi
BACKGROUND: Radiofrequency (RF) is a minimally invasive target-selective technique that has been used with success for many years in the treatment of different pathologies, such as low back pain, trigeminal neuralgia, and others. AIM: The aim of this study is to compare different mode of RF - continuous RF (CRF) versus pulsed RF (PRF) along with steroid in the management of low back pain of discogenic origin. SETTING AND DESIGN: Prospective, randomized, double-blind trial...
September 2016: Anesthesia, Essays and Researches
Federico Castillo-Álvarez, Ignacio Hernando de la Bárcena, María Eugenia Marzo-Sola
INTRODUCTION: Trigeminal neuralgia is one of the most disabling facial pain syndromes, with a significant impact on patients' quality of life. Pharmacotherapy is the first choice for treatment but cases of drug resistance often require new strategies, among which various interventional treatments have been used. In recent years a new therapeutic strategy consisting of botulinum toxin has emerged, with promising results. DEVELOPMENT: We reviewed clinical cases and case series, open-label studies and randomized clinical trials examining the use of botulinum toxin for drug-refractory trigeminal neuralgia published in the literature...
October 12, 2016: Medicina Clínica
Lei Xia, Ming-Xing Liu, Jun Zhong, Ning-Ning Dou, Bin Li, Hui Sun, Shi-Ting Li
Although the microvascular decompression (MVD) surgery has become an effective remedy for cranial nerve rhizopathies, it is still challengeable and may result in a fatal sequel sometimes. Therefore, the operative skill needs to be further highlighted with emphasis on the safety and a preplan for management of postoperative fatal complications should be established. We retrospectively analyzed 6974 cases of MVD. Postoperatively, 46 patients (0.66 %) presented decline in consciousness with a positive finger-nose test (or failure to be tested) after wake up from the anesthesia, whom were focused on in this study...
October 12, 2016: Neurosurgical Review
Christina L Szperka, Amy A Gelfand, Andrew D Hershey
OBJECTIVE: To describe current patterns of use of nerve blocks and trigger point injections for treatment of pediatric headache. BACKGROUND: Peripheral nerve blocks are often used to treat headaches in adults and children, but the available studies and practice data from adult headache specialists have shown wide variability in diagnostic indications, sites injected, and medication(s) used. The purpose of this study was to describe current practice patterns in the use of nerve blocks and trigger point injections for pediatric headache disorders...
October 12, 2016: Headache
David Daewhan Kim, Nabil Sibai
INTRODUCTION: Greater occipital nerve blocks (GONB) have been used for headache but their benefit may be short. Ready et al performed intrathecal injections on rabbits and reported neurologic/histologic changes that required concentrations of at least 8%. Our study tests the hypothesis that the neurolytic effects of GONB with 10% lidocaine can prolong relief. METHODS: After an approval from Henry Ford Hospital Institutional Review Board, a chart review was performed for patients who had GONB with 10% lidocaine...
2016: Journal of Pain Research
Nozomu Tanabe, Takahiro Tomita, Shoichi Nagai, Naoya Kuwayama, Kyo Noguchi, Satoshi Kuroda
The authors report a rare case of an intracranial dermoid cyst found in Meckel's cave. A 63-year-old woman developed left oculomotor nerve palsy and was referred to their hospital. Magnetic resonance imaging revealed a cystic lesion in the left Meckel's cave and prepontine cistern, but her symptoms gradually improved during conservative observation. However, three years later she complained of left facial pain in the territory of the second branch of the trigeminal nerve. The left oculomotor nerve palsy exacerbated again...
October 2016: No Shinkei Geka. Neurological Surgery
Chenlong Liao, Massimiliano Visocchi, Min Yang, Pengfei Liu, Shiting Li, Wenchuan Zhang
BACKGROUND: Pain relief comparable to radiofrequency thermocoagulation (RFT) alone and fewer side effects have been achieved by combination treatment with pulsed radiofrequency (PRF) and short-duration RFT in trigeminal neuralgia (TN). CASE DESCRIPTION: We report the successful management of recurrent TN following RFT with single PRF in two patients. The RFT treatment was performed in 2-3 cycles for each division with the lesion setting at 75-80°C for 90 s. The PRF treatment was applied for 120 s with a generator output of 45 V, not exceeding a temperature of 42°C at the tip of the electrode...
October 8, 2016: World Neurosurgery
Sheena Derry, Cathy Stannard, Peter Cole, Philip J Wiffen, Roger Knaggs, Dominic Aldington, R Andrew Moore
BACKGROUND: Opioid drugs, including fentanyl, are commonly used to treat neuropathic pain, and are considered effective by some professionals. Most reviews have examined all opioids together. This review sought evidence specifically for fentanyl, at any dose, and by any route of administration. Other opioids are considered in separate reviews. OBJECTIVES: To assess the analgesic efficacy of fentanyl for chronic neuropathic pain in adults, and the adverse events associated with its use in clinical trials...
October 11, 2016: Cochrane Database of Systematic Reviews
Yaron Haviv, Avraham Zini, Yoni Etzioni, Valeri Klitinich, Alex Dobriyan, Yair Sharav, Rafael Benoliel, Galit Almoznino
OBJECTIVE: To identify patient and pain characteristics associated with negative impacts on daily life among patients with chronic orofacial pain (COFP). STUDY DESIGN: Medical records of 200 COFP patients were analyzed. RESULTS: Diagnostic categories included temporomandibular disorders (85; 42.7%), headaches (47; 23.6%), neuropathic pain (37; 18.5%), trigeminal neuralgia (16; 8.0%), and painful posttraumatic trigeminal neuropathy (PTTN) (14; 7...
August 27, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Hans Prakash Sathasivam, Sumairi Ismail, Abdul Rahim Ahmad, Nor Nazaliza Basri, Hartinie Muhamad, Nur Fazilah Mohd Tahir, Chee Lynn Saw, Nurshaline Hj Kipli, Shin Hin Lau
OBJECTIVES: This study was performed to obtain the clinicodemographic data regarding patients with trigeminal neuralgia (TN) treated at oral-maxillofacial medicine clinics, as there is a paucity of such information in the Asian setting. STUDY DESIGN: Retrospective multicenter study involving clinicodemographic information of 320 patients with TN diagnosed between 2001 and 2012 at eight regional oral-maxillofacial medicine clinics and followed up for at least 6 months...
August 17, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Sira Carrasco García de León, José Manuel Flores Barragán, Natalia Villasanti Rivas
Sacrococcygeal chordoma is a malignant tumour originating from remnants of the notochord. Chordomas are slow-growing tumours whose symptoms develop insidiously. We present the case of a 72-year-old woman with a 6-month history of genital pain radiating to the perianal area and exacerbating when she was in a sitting position. MRI and PET studies revealed a large mass in the sacrococcygeal region causing bone destruction and invasion of neurovascular structures. The immunohistochemical study of the surgical specimen determined it to be chordoma...
May 2016: Case Reports in Neurology
Peter C Emary, John A Taylor
Perineural (Tarlov) cysts are rare and are usually asymptomatic and an incidental finding on routine spinal imaging. Presented here is a case of sciatic neuralgia in a 56-year-old patient whose clinical symptoms correlated with a lower lumbar perineural cyst.
September 2016: Journal of the Canadian Chiropractic Association
Wen-Yi Wang, Sing-Huh Liu, Meng-Yin Lin, Che-Chen Lin, I-Jong Wang
Herpes zoster (HZ) is associated with complications such as postherpetic neuralgia (PHN) and HZ ophthalmicus (HZO). However, few studies have focused on identifying patients having a high risk of PHN and HZO according to the initial presentation sites. The current study investigated these factors in a nationwide population-based cohort derived from Taiwan's Longitudinal Health Insurance Database. The results indicate that the initial presentation sites can predict the complication site of HZ. In this study, elderly patients were found to be more susceptible to HZ and were the first to present with neurological signs (HZN)...
2016: PloS One
Kajetan L von Eckardstein, Dorothee Mielke, Reza Akhavan-Sigari, Veit Rohde
Background and Study Aims In microvascular decompression of the trigeminal nerve for trigeminal neuralgia (TN), the site of conflict is occasionally difficult to identify. Endoscopy has been described to better evaluate the anatomical conflict in such situations. We hypothesized that indocyanine green (ICG) angiography could allow for better visualization of the compressing artery and its anatomical relation to the nerve. Material and Methods ICG angiography was performed in 17 TN patients undergoing microvascular decompression...
September 23, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Theresa Mallick-Searle, Brett Snodgrass, Jeannine M Brant
Herpes zoster, also known as shingles, is a distinctive clinical condition caused by the reactivation of latent varicella zoster (chickenpox) virus following an initial infection. Approximately 1 million cases of herpes zoster occur annually in the US, and one in every three people develops herpes zoster during their lifetime. Postherpetic neuralgia is a neuropathic pain syndrome characterized by pain that persists for months to years after resolution of the herpes zoster rash. It stems from damage to peripheral and central neurons that may be a byproduct of the immune/inflammatory response accompanying varicella zoster virus reactivation...
2016: Journal of Multidisciplinary Healthcare
Muhammad Laklouk, Ganesan Baranidharan
Capsaicin is a naturally occurring irritant active ingredient found in hot peppers. It is a ligand for transient receptor potential channel vanilloid receptors, which are found in nociceptive nerve terminals in the skin. Initial exposure to topical capsaicin leads to excitation of these receptors, release of vasoactive mediators, erythema, intense burning, pain, and thereafter desensitization of sensory neurons resulting in inhibition of pain transmission. Capsaicin 8% has been licensed for the treatment of postherpetic neuralgia pain in recent years...
2016: Patient Preference and Adherence
Srinivas Chivukula, Won Kim, Xiaoyi Zhuo, Stephen Tenn, Tania Kaprealian, Antonio DeSalles, Nader Pouratian
BACKGROUND: The mechanisms by which surgery and radiation elicit pain relief in trigeminal neuralgia (TN) secondary to mass lesions vary widely. We aimed to evaluate the outcomes of radiation to the nerve rather than to the lesion in the treatment of secondary TN. METHODS: We retrospectively reviewed all patients who underwent radiation at the University of California, Los Angeles for TN secondary to tumors. The Barrow Neurological Institute (BNI) pain score was used to evaluate pain outcomes...
October 1, 2016: World Neurosurgery
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