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Trigeminal neuralgia and nerve

Tian Tian, Linying Guo, Jing Xu, Shun Zhang, Jingjing Shi, Chengxia Liu, Yuanyuan Qin, Wenzhen Zhu
Peripheral nerve damage does not fully explain the pathogenesis of trigeminal neuralgia (TN). Central nervous system changes can follow trigeminal nerve dysfunction. We hypothesized that brain white matter and functional connectivity changes in TN patients were involved in pain perception, modulation, the cognitive-affective system, and motor function; moreover, changes in functional reorganization were correlated with white matter alterations. Twenty left TN patients and twenty-two healthy controls were studied...
October 25, 2016: Scientific Reports
Matthew J Zdilla, Scott A Hatfield, Kelsey R Mangus
The debilitating pain of trigeminal neuralgia often necessitates neurosurgical intervention via percutaneous transovale cannulation. While most percutaneous treatments of trigeminal neuralgia are successful, severe adverse events resulting from failure to properly cannulate the foramen ovale (FO) have been reported. With regard to specific targeting of particular trigeminal divisions (ie, V1, V2, V3, and combinations thereof), operative techniques have been described; however, these descriptions have not included specific angulation data...
October 14, 2016: Journal of Craniofacial Surgery
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)
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
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
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
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
Herta Flor, Dirk Rasche, Ariyan Pirayesh Islamian, Claudia Rolko, Pinar Yilmaz, Marc Ruppolt, H Holger Capelle, Volker Tronnier, Joachim K Krauss
BACKGROUND: Trigeminal neuralgia (TN) is characterized by paroxysmal pain attacks affecting the somatosensory distributions of the trigeminal nerve. It is thought to be associated with a neurovascular conflict most frequently, but pathomechanisms have not been fully elucidated. In general, no sensory deficit is found in routine clinical examination. There is limited data available, however, showing subtle subclinical sensory deficits upon extensive testing. OBJECTIVE: We used quantitative sensory testing (QST) to detect abnormalities in sensory processing in patients with TN by comparing the affected and non-affected nerve branches with their contralateral counterparts and by comparing the results of the patients with those of controls...
September 2016: Pain Physician
Nabil Ail Elsheikh, Yasser M Amr
BACKGROUND: Pharmacotherapy is the main treatment for management of trigeminal neuralgia. However, many patients become refractory to drugs. OBJECTIVES: The present study aimed to evaluate the effect of adding calcitonin to local anesthetic and methylprednisolone using a modified coronoid approach in management of trigeminal neuralgia pain involving the mandibular and/or maxillary branches. STUDY DESIGN: Randomized double blind clinical trial...
September 2016: Pain Physician
Fuminari Komatsu, Masaaki Imai, Akihiro Hirayama, Kazuko Hotta, Naokazu Hayashi, Shinri Oda, Masami Shimoda, Mitsunori Matsumae
Background Endoscopic microvascular decompression (MVD) offers reliable identification of neurovascular conflicts under superb illumination, and it provides minimally invasive surgery for trigeminal neuralgia and hemifacial spasm. Transposition techniques have been reported as a decompression method to prevent adhesion and granuloma formation around decompression sites, providing better surgical outcomes. The feasibility and effects of transposition under endoscopic MVD were evaluated. Material and Methods Fully endoscopic MVD was performed using 4-mm 0- and 30-degree endoscopes...
September 5, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Yongxu Wei, Chunhua Pu, Ning Li, Yu Cai, Hanbing Shang, Weiguo Zhao
AIM: This study evaluated the long-term efficacy and safety of microvascular decompression (MVD) for treating trigeminal neuralgia (TN), and identified the predictors of pain relief. MATERIAL AND METHODS: A total of 425 patients who underwent surgery between 1991 and 2011 for idiopathic TN were included in this study. Pain outcome was graded using the Barrow Neurological Institute pain scale, success was defined as complete pain relief without medication. A Kaplan-Meier survival curve was generated...
August 5, 2016: Turkish Neurosurgery
Yatin Kher, Nishtha Yadav, Yad Ram Yadav, Vijay Parihar, Shailendra Ratre, Jitin Bajaj
AIM: Microscope may fail to detect culprit vessel at the root entry zone or distally especially when suprameatal tubercle is prominent and when compressing vessel is lying anteriorly to trigeminal nerve without using significant brain retraction. Endoscopic techniques allow better visualization of nerve and vascular conflict. MATERIAL AND METHODS: A retrospective study of 178 patients of endoscopic vascular decompression without use of microscope was done. The follow-up period ranged from 12 to 108 months (average 58 months)...
May 25, 2016: Turkish Neurosurgery
Kentaro Watanabe, R Shane Tubbs, Shunsuke Satoh, Ali R Zomorodi, Wolfgang Liedtke, Moujahed Labidi, Allan H Friedman, Takanori Fukushima
: Glossopharyngeal, nervus intermedius and vagus neuralgias can all present with ear pain. However, to our knowledge, there have been no reports of otalgia as the only symptom of vagus neuralgia. The seventh, ninth and tenth cranial nerves have many interneural connections and the exact anatomy and pathophysiology of these neuralgias is often not clear. Moreover, symptoms due to involvement of any of these nerves can be difficult to attribute solely to one of them. The overlapping sensory innervation of the external auditory canal can lead to misdiagnosis in patients suffering from otalgia...
September 1, 2016: World Neurosurgery
Vicente Vanaclocha, Juan Manuel Herrera, Deborah Martínez-Gómez, Marlon Rivera-Paz, Cristina Calabuig-Bayo, Leyre Vanaclocha
BACKGROUND: surgical treatment of trigeminal neuralgia (TN) associated with vertebro-basilar dolichoectasia (VBD) is challenging. AIM: to analyze the treatments for this disease discussing its advantages and drawbacks, presenting our own technique and series. METHODS: retrospective study January 2006-January 2016. On pre and postop MRI images VBD deviation from midline, BA and VA diameter, and BA apex distance above posterior clinoid process were measured...
August 29, 2016: World Neurosurgery
Seong-Cheol Park, Do Hee Lee, Jung Kyo Lee
OBJECTIVE: To investigate gamma knife radiosurgery (GKS) for benign tumor-associated secondary trigeminal neuralgia. METHODS: From 2006 to 2015, 21 patients with secondary trigeminal neuralgia from meningioma were treated using GKS. Their mean age was 56.5 ± 12.2 years. The 50% isodose was 12.5±1.1 Gy for the first GKS for the meningioma. Retrogasserian targeting of the trigeminal nerve at 90 Gy with a 4-mm collimator was used for the second GKS. RESULTS: The pain duration until GKS was 1...
August 27, 2016: World Neurosurgery
Zi-Feng Dai, Qi-Lin Huang, Hai-Peng Liu, Wei Zhang
OBJECTIVES: A retrospective study was undertaken to compare the efficacy of stereotactic gamma knife surgery (GKS) and microvascular decompression (MVD) in the treatment of primary trigeminal neuralgia (TN) at a single center. The study included the evaluation of clinical outcomes of pain relief and pain recurrence and complications associated with GKS and MVD. METHODS: The study included 202 patients with primary TN and was conducted between January 2013 and December 2014; about 115 patients were treated with GKS and 87 patients were treated with MVD...
2016: Journal of Pain Research
Giovanni Grasso, Alessandro Landi, Concetta Alafaci
Trigeminal neuralgia (TN) is a form of neuropathic pain that affects the fifth cranial nerve, the most widely distributed nerve in the head. Although TN has been associated with a variety of pathological conditions, neurovascular compression on the trigeminal nerve, as it exits the brain stem, is the most frequent reported cause. This compression provides a progressive demyelination of the nerve and a subsequent aberrant neural transmission. Although several studies have clarified some physiopathological mechanisms underlying TN, the molecular basis remains vague...
August 11, 2016: Molecular Medicine
Vijayan Ganesan, Dhrubajyoti Bandyopadhyay, Suvrendu Sankar Kar, Cankatika Choudhury, Vivek Choudhary
Herpes zoster is a unilateral painful vesicular cutaneous eruption caused by the reactivation of the Varicella zoster virus. It commonly affects the older people and immunocompromised individuals. The dermatomes from T3 to L3 are most frequently involved. Its three stages include prodromal stage, active stage and chronic stage. The common complications of the infection include post-herpetic neuralgia, Ramsay Hunt syndrome, Guillain-Barre syndrome, transverse myelitis and encephalomyelitis. This case report summarizes a very rare association of herpes zoster meningitis with the involvement of mandibular division of the trigeminal nerve and facial nerve...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Yu A Shulev, K S Gordienko, A V Trashin, D A Pechiborshch, D A Rzaev
AIM: The study objective was to verify venous compression as a cause of trigeminal neuralgia (TN) and to define the optimal surgical tactics for TN patients. MATERIAL AND METHODS: Four hundred twenty one patients were operated on for TN at the Neurosurgical Department of the City Hospital №2 from 1998 to 2015. Veins in the trigeminal nerve root entry zone, as a significant compression factor, were identified in 40 patients (9.5%). Intraoperative data, questionnaires, and self-assessment inventories were analyzed...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Brian S Tanaka, Peng Zhao, Fadia B Dib-Hajj, Valerie Morisset, Simon Tate, Stephen G Waxman, Sulayman D Dib-Hajj
Idiopathic trigeminal neuralgia (TN) is a debilitating pain disorder characterized by episodic unilateral facial pain along the territory of branches of the trigeminal nerve. Human painful disorders, but not TN, have been linked to gain-of-function mutations in peripheral voltage-gated sodium channels (NaV1.7, NaV1.8 and NaV1.9). Gain-of-function mutations in NaV1.6, which is expressed in myelinated and unmyelinated CNS and peripheral nervous system neurons and supports neuronal high-frequency firing, have been linked to epilepsy but not to pain...
August 3, 2016: Molecular Medicine
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