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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 -
Current Pain and Headache Reports Apr 2024Trigeminal postherpetic neuralgia (TG-PHN) is a neuropathic pain condition complicating herpes zoster (HZ) attributed to the trigeminal nerve. It poses significant... (Review)
Review
PURPOSE OF REVIEW
Trigeminal postherpetic neuralgia (TG-PHN) is a neuropathic pain condition complicating herpes zoster (HZ) attributed to the trigeminal nerve. It poses significant challenges due to its persistent and debilitating nature. This review explores the clinical characteristics of TG-PHN, analyzes its pathophysiological underpinnings, and addresses existent and potential therapies.
RECENT FINDINGS
TG-PHN is one of the most common and complex PHN locations. It has distinguishing clinical and pathophysiological characteristics, starting with viral triggered injuries to the trigeminal ganglion (TG) and peripheral tissue and involving the ascending and descending brain modulation pathways. Current therapies include vaccines, oral and topical medications, and interventional approaches, like nerve blocks and neurostimulation. This review covers TG-PHN's clinical and physiological components, treatment options, and potential future targets for improved management. By exploring the complexities of this condition, we aim to contribute to developing more effective and targeted therapies for patients suffering from trigeminal PHN.
Topics: Humans; Neuralgia, Postherpetic; Neuralgia; Herpes Zoster; Trigeminal Neuralgia; Nerve Block
PubMed: 38261232
DOI: 10.1007/s11916-023-01209-z -
Ideggyogyaszati Szemle Nov 2022Trigeminal neuralgia is a severe neuropathic disorder, affecting the distribution area of the trigeminal nerve and often impairs the quality of life of patients. More... (Review)
Review
Trigeminal neuralgia is a severe neuropathic disorder, affecting the distribution area of the trigeminal nerve and often impairs the quality of life of patients. More and more scholars agree that one of the pathogenesis of trigeminal neuralgia is due to the demyelinating lesion caused by vascular compression or arachnoid bundle wrapping on the root exit zone of trigeminal nerve. In this regard, the most effective method is microvascular decompression, which can relieve the compression of the offending vessels and the thickened arachnoid on the trigeminal nerve. However, it still has some disadvantages, such as the possibility of fatal complications. In recent years, with the advancement of neurosurgical treatment technology, new progress has been made in microvascular decompression. This article mainly introduces the surgical techniques and new methods of the microvascular decompression.
Topics: Humans; Microvascular Decompression Surgery; Trigeminal Neuralgia; Quality of Life; Trigeminal Nerve; Neurosurgical Procedures; Decompression, Surgical
PubMed: 36541149
DOI: 10.18071/isz.75.0369 -
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 -
Indian Journal of Pharmacology 2022Trigeminal neuralgia (TN) is an episodic facial pain which feels like an electric shock of unilateral origin. This neuropathic disorder is an intensely stressful to bear... (Review)
Review
Trigeminal neuralgia (TN) is an episodic facial pain which feels like an electric shock of unilateral origin. This neuropathic disorder is an intensely stressful to bear for patient and impacts the quality of life. Most of the cases of TN arise when the root of fifth cranial nerve, i.e., trigeminal nerve is compressed after a few millimeters of its entry into the pons. This article describes various animal models and the role of biomarkers to study the underlying mechanisms of neuropathic pain in animal models as well as different modes of management of TN.
Topics: Animals; Facial Pain; Humans; Models, Animal; Quality of Life; Trigeminal Nerve; Trigeminal Neuralgia
PubMed: 35546466
DOI: 10.4103/ijp.ijp_296_19 -
Ugeskrift For Laeger Jul 2016Trigeminal neuralgia (TN) is characterized by unilateral evoked short-lasting intense pain paroxysms in the face. A concomitant persistent background pain is frequently... (Review)
Review
Trigeminal neuralgia (TN) is characterized by unilateral evoked short-lasting intense pain paroxysms in the face. A concomitant persistent background pain is frequently present. Neurovascular contact causing displacement or atrophy of the trigeminal nerve is important to TN aetiology. TN can also be secondary to a space-occupying lesion or multiple sclerosis. Early high-quality magnetic resonance imaging is mandatory as a part of the work-up. First-choice treatment is medical. Medically refractory patients are referred to neurosurgery. Nationwide in Denmark, there is a need for structured and uniform treatment of TN.
Topics: Anticonvulsants; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Microvascular Decompression Surgery; Trigeminal Nerve; Trigeminal Neuralgia
PubMed: 27460468
DOI: No ID Found -
Cirugia Y Cirujanos 2022Trigeminal neuralgia is a painful disorder of the face that negatively affects the functionality of those who suffer from it. Microvascular decompression remains the top...
Trigeminal neuralgia is a painful disorder of the face that negatively affects the functionality of those who suffer from it. Microvascular decompression remains the top choice for its short and long-term outcomes. In those who are not candidates for open surgery, ablative options become valuable, including radiosurgery, and radiofrequency, balloon, and glycerol rhizotomies. Radiosurgery can be useful in cases of trigeminal neuralgia associated with multiple sclerosis. A scheme is proposed to facilitate decision-making considering outcomes, predictors of response and complication rates.
Topics: Adult; Humans; Microvascular Decompression Surgery; Radiosurgery; Rhizotomy; Treatment Outcome; Trigeminal Neuralgia
PubMed: 35944472
DOI: 10.24875/CIRU.20000772 -
Current Neuropharmacology 2021Trigeminal neuralgia is a chronic disease characterized by intense facial pain that is caused by trigeminal nerve affectation. It usually affects adults from 50 years of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Trigeminal neuralgia is a chronic disease characterized by intense facial pain that is caused by trigeminal nerve affectation. It usually affects adults from 50 years of age, and is more frequent in women. Additionally, it presents serious psychological effects that often lead to depression, which is why it is considered highly disabling. The therapeutic approach is based on the modification of nerve activity through electrical, surgical or chemical stimulation in specific regions of the nervous system.
OBJECTIVE
To perform a meta-analysis of the scientific literature related to invasive and non-invasive electrical neuromodulation of trigeminal neuralgia, in order to assess their effects over pain and adverse effects.
METHODS
A literature search was conducted in 4 databases, followed by a manual search of articles on invasive or non-invasive electrical neuromodulation to control the pain of trigeminal neuralgia, including the last 15 years.
RESULTS
Regarding non-invasive methods, clinical trials did not present enough results in order to perform a meta-analysis. Regarding invasive methods, clinical trials meta-analysis showed no statistical differences between different treatment methods. In all cases, improvements in patients' pain were reported, although results regarding adverse effects were variable.
CONCLUSION
In the treatment of trigeminal neuralgia, the continuous radiofrequency provides better short and medium-term results, but pulsed radiofrequency shows less adverse effects after treatment, and has better results in the long-term.
Topics: Adult; Chronic Disease; Female; Humans; Neuralgia; Treatment Outcome; Trigeminal Nerve; Trigeminal Neuralgia
PubMed: 32727329
DOI: 10.2174/1570159X18666200729091314 -
Neurological Sciences : Official... Dec 2023It is well established that trigeminal neuralgia is more prevalent in females than in males. Neurovascular compression with morphological changes of the trigeminal root...
BACKGROUND
It is well established that trigeminal neuralgia is more prevalent in females than in males. Neurovascular compression with morphological changes of the trigeminal root represents the most recognized etiological factor. However, other factors may play a role in the framework of a multi-hit model. The primary aim of this study was to investigate sex differences in radiological and clinical characteristics of trigeminal neuralgia to better understand the multifactorial origin of this peculiar neuropathic pain condition.
METHODS
In this cross-sectional study patients with a definite diagnosis of primary trigeminal neuralgia were consecutively enrolled. Each patient underwent 3T MRI with sequences dedicated to the study of neurovascular compression. Major morphological changes of the trigeminal root were quantitatively assessed. Clinical characteristics were systematically collected through a dedicated questionnaire. A logistic regression model was implemented to predict radiological and clinical characteristics based on sex.
RESULTS
A total of 114 patients with classical (87) or idiopathic trigeminal neuralgia (27) were enrolled. Female sex was predictive for idiopathic trigeminal neuralgia. Male sex was predictive, among the comorbidities and clinical characteristics, for hypertension, the involvement of the left side and the second trigeminal division, alone or with the ophthalmic division.
DISCUSSION
The preponderance of TN in the female sex and the association between idiopathic TN and the female sex suggest the role of additional etiological factors in the framework of a multi-hit model. The identification of clinical variables predicted by sex suggests the possibility that distinct phenotypes, with peculiar pathophysiological and therapeutic aspects, may occur in females and males.
Topics: Humans; Male; Female; Trigeminal Neuralgia; Sex Characteristics; Cross-Sectional Studies; Radiography; Magnetic Resonance Imaging; Trigeminal Nerve
PubMed: 37436558
DOI: 10.1007/s10072-023-06923-5 -
Medicina (Kaunas, Lithuania) Mar 2022: Managing people with trigeminal neuralgia (TN) and osteoporosis is challenging due to their debilitating conditions. Currently, the exact association between TN and...
: Managing people with trigeminal neuralgia (TN) and osteoporosis is challenging due to their debilitating conditions. Currently, the exact association between TN and osteoporosis in patients remains unknown, although there is potential overlapping of pathophysiological mechanisms. In response, we calculated TN risk in patients who have osteoporosis. : 45,393 patients aged over 50 years diagnosed with osteoporosis were matched with 45,393 non-osteoporosis patients aged over 50 years (1:1 ratio) who were used as the control group, using data from 1996 to 2010 from Taiwan's National Health Insurance Research Database. The cumulative incidences of subsequent TN and the hazard ratio were estimated using Cox proportional hazards modeling and the Kaplan-Meier method, respectively. : Among the total sample, 333 patients were diagnosed with TN during the follow-up period: 205 in the osteoporosis cohort and 128 in the control cohort. Through covariate adjustment, the overall TN incidence showed a 1.80-fold increase in the osteoporosis cohort in comparison with the control cohort (0.60 vs. 0.18 per 1000 person-years, respectively). The High Charlson Comorbidity Index, hypertension, and migraines were risk factors of TN. : Osteoporosis patients had a higher TN risk than that of the control cohort. Therefore, early recognition of pain and symptoms in osteoporotic people may help to identify possible TN patients who need prompt therapy.
Topics: Aged; Cohort Studies; Humans; Incidence; Osteoporosis; Retrospective Studies; Trigeminal Neuralgia
PubMed: 35334622
DOI: 10.3390/medicina58030447