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Acta Neurochirurgica May 2024Based on a personal experience of 4200 surgeries, radiofrequency thermocoagulation is useful lesional treatment for those trigeminal neuralgias (TNs) not amenable to... (Review)
Review
Based on a personal experience of 4200 surgeries, radiofrequency thermocoagulation is useful lesional treatment for those trigeminal neuralgias (TNs) not amenable to microvascular decompression (idiopathic or secondary TNs). Introduced through the foramen ovale, behind the trigemnial ganglion in the triangular plexus, the needle is navigated by radiology and neurophysiological testing to target the retrogasserian fibers corresponding to the trigger zone. Heating to 55-75 °C can achieve hypoesthesia without anaesthesia dolorosa if properly controlled. Depth of anaesthesia varies dynamically sedation for cannulation and lesioning, and awareness during neurophysiologic navigation. Proper technique ensures long-lasting results in more than 75% of patients.
Topics: Trigeminal Neuralgia; Humans; Electrocoagulation; Trigeminal Nerve; Foramen Ovale; Trigeminal Ganglion; Microvascular Decompression Surgery; Treatment Outcome
PubMed: 38727725
DOI: 10.1007/s00701-024-06074-2 -
Journal of Neurophysiology Feb 2020Blinking sustains the corneal tear film generated by sexually dimorphic lacrimal and meibomian glands. Our study examines whether trigeminal control of blinking is also...
Blinking sustains the corneal tear film generated by sexually dimorphic lacrimal and meibomian glands. Our study examines whether trigeminal control of blinking is also sexually dimorphic by investigating trigeminal reflex blinking, associative blink modification, and spontaneous blinking in male and female rats before and after unilateral dry eye caused by exorbital gland removal. Before gland removal, female rats exhibited a lower threshold for evoking trigeminal reflex blinks, a weaker effect of associative blink modification, and longer-duration spontaneous blinks than males. Spontaneous blink rate, reflex blink excitability, and occurrence of blink oscillations did not differ between the sexes. Reanalysis of previous data showed that humans showed the same blink sexual dimorphisms as rats. During the first 2 wk of dry eye, trigeminal blink circuit excitability and blink oscillations steadily rose in male rats, whereas excitability and blink oscillations did not change in females. Following dry eye, spontaneous blink duration increased for both males and females, whereas spontaneous blink rate remained constant for males but decreased for females. The associative modification treatment to depress trigeminal blink amplitude initially produced blink depression in males that converted to blink potentiation as trigeminal excitability rose, whereas females exhibited progressively more blink depression. These data indicated that dry eye increased excitability in male trigeminal reflex blink circuits at the expense of circuit modifiability, whereas trigeminal modifiability increased in females. This increased modifiability of female trigeminal blink circuits with dry eye may contribute to the preponderance of females developing the focal dystonia, benign essential blepharospasm. All the elements controlling the corneal tear film are sexually dimorphic. Blinking, which smooths and maintains the tear film, also exhibits sex differences. Dry eye increases the sexual dimorphisms of blinking, including increased exaggeration of excitability in males and enhanced modifiability of the female trigeminal complex. This increased modifiability may explain female predominance in the development of the focal dystonia, benign essential blepharospasm.
Topics: Animals; Blepharospasm; Blinking; Dry Eye Syndromes; Female; Male; Rats; Rats, Sprague-Dawley; Sex Characteristics; Trigeminal Nerve
PubMed: 31940243
DOI: 10.1152/jn.00635.2019 -
Korean Journal of Radiology Aug 2022To determine the anatomical characteristics of the petrous ridge and trigeminal nerve in trigeminal neuralgia (TN) without neurovascular compression (NVC).
OBJECTIVE
To determine the anatomical characteristics of the petrous ridge and trigeminal nerve in trigeminal neuralgia (TN) without neurovascular compression (NVC).
MATERIALS AND METHODS
From May 2017 to March 2021, 66 patients (49 female and 17 male; mean age ± standard deviation [SD], 56.8 ± 13.3 years) with TN without NVC and 57 controls (46 female and 11 male; 52.0 ± 15.6 years) were enrolled. The angle of the petrous ridge (APR) and angle of the trigeminal nerve (ATN) were measured using magnetic resonance imaging with a high-resolution three-dimensional T2 sequence. Data on the symptomatic side were compared with those on the asymptomatic side in patients and with the mean measurements of the bilateral sides in controls. Receiver operating characteristic (ROC) analysis was conducted to evaluate the performance of APR and ATN in distinguishing TN patients from controls.
RESULTS
In TN patients without NVC, the mean ± standard deviation (SD) of APR on the symptomatic side (98.40° ± 19.75°) was significantly smaller than that of the asymptomatic side (105.59° ± 22.45°, = 0.019) and controls (108.44° ± 15.98°, = 0.003). The mean ATN ± SD on the symptomatic side (144.41° ± 8.92°) was significantly smaller than that of the asymptomatic side (149.67° ± 8.09°, = 0.003) and controls (150.45° ± 8.48°, = 0.001). The area under the ROC curve for distinguishing TN patients from controls was 0.673 (95% confidence interval [CI]: 0.579-0.758) for APR and 0.700 (CI: 0.607-0.782) for ATN. The sensitivity and specificity using the diagnostic cutoff yielding the highest Youden index were 81.8% (54/66) and 49.1% (28/57), respectively, for APR (with a cutoff score of 94.30°) and 65.2% (43/66) and 66.7% (38/57), respectively, for ATN (cutoff score, 148.25°).
CONCLUSION
In patients with TN without NVC, APR and ATN were smaller than those in controls, which may explain the potential cause of TN and provide additional information for diagnosis.
Topics: Female; Humans; Magnetic Resonance Imaging; Male; Trigeminal Nerve; Trigeminal Neuralgia
PubMed: 35695314
DOI: 10.3348/kjr.2021.0771 -
Pain Mar 2011
Review
Topics: Animals; Facial Pain; Humans; Models, Neurological; Nerve Net; Trigeminal Nerve
PubMed: 21292394
DOI: 10.1016/j.pain.2010.12.024 -
Lakartidningen Dec 2014
Topics: Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Trigeminal Nerve; Trigeminal Neuralgia
PubMed: 25514666
DOI: No ID Found -
Neuromodulation : Journal of the... Dec 2022Trigeminal nerve stimulation (TNS) is a promising strategy in treating diseases of the nervous system. In this study, the effects of TNS on traumatic brain injury (TBI)...
OBJECTIVES
Trigeminal nerve stimulation (TNS) is a promising strategy in treating diseases of the nervous system. In this study, the effects of TNS on traumatic brain injury (TBI) were investigated in a mouse model.
MATERIALS AND METHODS
TBI was induced using a weight-drop device, and TNS treatment was delivered in the first hour after the TBI. Twenty-four hours later, the mice's behavior, brain edema, and expression of inflammatory factors were tested. Functional magnetic resonance imaging also was used to explore the possible effects of TNS on brain activity.
RESULTS
TNS alleviates TBI-induced neurological dysfunction in animal behavior tests, besides protecting the blood-brain barrier and reducing the level of brain edema. TNS also effectively reduces the level of tumor necrosis factor-α and interleukin 6 and downregulates the cleaved caspase-3 signaling pathway. A series of brain areas was found to be possibly regulated by TNS, thus affecting the neural functions of animals.
CONCLUSION
This study elucidates the role of TNS as an effective treatment for TBI by inhibiting the occurrence of a secondary brain injury.
Topics: Animals; Mice; Brain Edema; Brain Injuries; Brain Injuries, Traumatic; Trigeminal Nerve
PubMed: 35088758
DOI: 10.1016/j.neurom.2021.10.014 -
Journal of Medicine and Life 2013Trigeminal neuralgia (TN) is defined as sudden, usually unilateral, severe, brief, stabbing recurrent episodes of pain within the distribution of one or more branches of... (Review)
Review
Trigeminal neuralgia (TN) is defined as sudden, usually unilateral, severe, brief, stabbing recurrent episodes of pain within the distribution of one or more branches of the trigeminal nerve. It is the most frequent cranial neuralgia, the incidence being 1 per 1,000,00 persons per year. Pain attacks start abruptly and last several seconds but may persist 1 to 2 minutes. The attacks are initiated by non painful physical stimulation of specific areas (trigger points or zones) that are located ipsilateral to the pain. After each episode, there is usually a refractive period during which stimulation of the trigger zone will not induce the pain. According to the European Federation of Neurological Societies (EFNS) guidelines on neuropathic pain assessment and the American Academy of Neurology (AAN)-EFNS guidelines on TN management the neurophysiological recording of trigeminal reflexes represents the most useful and reliable test for the neurophysiological diagnosis of trigeminal pains. The present article discusses different techniques for investigation of the trigeminal system by which an accurate topographical diagnosis and profile of sensory fiber pathology can be determined. With the aid of neurophysiological recordings and quantitative sensory testing, it is possible to approach a mechanism-based classification of orofacial pain.
Topics: Humans; Neuralgia; Neurophysiology; Trigeminal Nerve; Trigeminal Neuralgia
PubMed: 24701256
DOI: No ID Found -
Acta Medica Portuguesa 1999The lesion of the sensorial nerves of the face is expressed by painful phenomena called neuralgias of the brainstem or its branches. These may be idiopathic or essential... (Review)
Review
The lesion of the sensorial nerves of the face is expressed by painful phenomena called neuralgias of the brainstem or its branches. These may be idiopathic or essential and secondary or symptomatic and their clinical evidence and course are different from the former. Essential neuralgia (E.N.), or tic douloureux, is the most frequent facial pain neuralgia. The aim of this paper is to review this subject with evidence of secondary trigeminal neuralgia from oral causes (dental, traumatic, post herpes zoster, etc). The author establishes the differential diagnoses with other etiologies of facial pain and mentions the diagnostic criteria for trigeminal neuralgia (T.N.), makes the difference between essential neuralgia (E.N.) and symptomatic neuralgia (S.N.); describes briefly the different kinds of the medical and surgical therapy, its management and complications. The author finishes by asserting that all E.N. must complementary means of diagnosis (Base skull, X rays, C.T. scan, M.R.I.). Peripheral surgery has more relapses and less morbidity than neuro-surgical techniques. Under these circumstances latter must considered by the patient's, or his relatives, opinion.
Topics: Adult; Diagnosis, Differential; Disease Progression; Humans; Middle Aged; Trigeminal Nerve; Trigeminal Neuralgia
PubMed: 10481321
DOI: No ID Found -
Neurology Feb 2023
Topics: Humans; Optic Disk; Nevus, Pigmented; Trigeminal Nerve; Skin Neoplasms
PubMed: 36443010
DOI: 10.1212/WNL.0000000000201570 -
Experimental Eye Research Feb 2022The cornea is transparent and innervated by a dense collection of sensory nerves originating from the ocular branch of the trigeminal nerve. This study was designed to...
The cornea is transparent and innervated by a dense collection of sensory nerves originating from the ocular branch of the trigeminal nerve. This study was designed to comprehensively analyze alterations of corneal sub-basal nerve plexus in a mouse model of tauopathy (P301L transgenic mice) to test the possibility of using corneal nerves as a biomarker for tauopathy. Corneal sensitivity, thickness and epithelial wound healing were measured non-invasively by aeshesiometer, optical coherence tomography and fluorescein staining, respectively. Tau, corneal nerves and immune cells were examined by immunohistochemistry or Western blot. At the early stage of tauopathy, although corneal sensitivity, thickness and nerve fiber density were not greatly altered, corneal nerve abnormalities were observed in the peripheral region of young P301L mice. With aging, the density of abnormal nerves increased, while corneal sensitivity, epithelial thickness, nerve fiber density and length decreased in middle-aged P301L mice compared with WT mice. After corneal epithelial injury in young mice, no difference in reepithelialization was observed between two groups of mice, however, the regeneration of corneal nerves in P301L mice lagged behind WT mice, which was reflected by delayed recovery of corneal sensitivity, decreased corneal nerve density and length and density of CD45 dendriform cells in P301L mice. In conclusion, our data provide compelling evidence that corneal nerves were changed in a mouse model of tauopathy in an age-dependent manner. Moreover, tau overexpression impairs corneal nerve regeneration. These results suggest that cornea may serve as a promising ocular site for the early diagnosis of tauopathy.
Topics: Animals; Cornea; Corneal Diseases; Corneal Injuries; Disease Models, Animal; Mice; Nerve Regeneration; Tauopathies; Trigeminal Nerve
PubMed: 34929160
DOI: 10.1016/j.exer.2021.108900