Cases reported "Trigeminal Neuralgia"

Filter by keywords:



Filtering documents. Please wait...

1/19. Use of computed tomography for maxillary nerve block in the treatment of trigeminal neuralgia.

    BACKGROUND AND OBJECTIVES: maxillary nerve block has traditionally been performed by using external anatomic landmarks. However, the classic approach to the nerve may be confounded because of anatomic variability. We describe a technique for the block using the suprazygomatic route guided by computed tomography (CT). CASE REPORT: A 90-year-old woman had a 30-year history of episodic pain in her right maxillary region. We attempted to block the maxillary nerve with classic technique, but we could not identify the nerve by eliciting paresthesia. In addition, bleeding was noted after repeated attempts. To minimize complications and confirm the correct position of the needle tip, we planned the block with a suprazygomatic approach using CT guidance. The needle was inserted without paresthesia. The CT scan showed the needle tip was placed at the entrance of the pterygopalatine fossa and the distribution of contrast medium spread appropriately around the pterygopalatine fossa. After confirming the clinical effect and lack of complications of the block using the local anesthetic, 0.5 mL of 7% phenol was injected. This technique resulted in complete sensory loss in the area innervated by the maxillary nerve, and did so without complications. CONCLUSIONS: A maxillary nerve block guided by a CT imaging is an alternative to classic techniques.
- - - - - - - - - -
ranking = 1
keywords = nerve block, block
(Clic here for more details about this article)

2/19. cryotherapy in the management of trigeminal neuralgia: a review of the literature and report of three cases.

    trigeminal neuralgia is a unique neuropathic syndrome confined to the trigeminal system with no analog in the somatic dermatomes or the other cranial nerves. Medical treatment remains the first line of treatment with carbamezapine as the drug of choice. Surgery, central or peripheral is indicated when medical treatment fails or its side effects diminishes quality of life. No surgery offers a permanent cure. recurrence rates are highest in the most peripheral techniques but these also have the lowest morbidity. cryotherapy produces a reliable, prolonged and reversible nerve block with no aggravation of symptoms. It is a simple and repeatable procedure in patients who want to avoid major surgery or where it is contra-indicated.
- - - - - - - - - -
ranking = 0.16593644710684
keywords = nerve block, block
(Clic here for more details about this article)

3/19. Long-term pain control in trigeminal neuralgia with local anesthetics using an indwelling catheter in the mandibular nerve.

    OBJECTIVE: The authors sought to determine the usefulness of long-term continuous trigeminal nerve block with local anesthetics using an indwelling catheter in a patient with trigeminal neuralgia. DESIGN: The study design included pain control in a patient with trigeminal neuralgia until the time of neurosurgical operation. SETTING: The study was conducted in the Dental Hospital of tokyo Medical and Dental University. PATIENT: The patient was a 78-year-old woman with trigeminal neuralgia in the right maxillary region. Her pain could not be controlled by carbamazepine and was unbearable. INTERVENTION: The authors estimated the patient's pain intensity, quality, and locality using a visual analog scale to determine the effectiveness of continuous nerve block. OUTCOME MEASURES: Visual analog scores were measured during treatment. The treatment term was divided into three periods according to the difference of the catheter location and injection protocol (premandibular nerve block, infuser injection, and patient-controlled analgesia [PCA] pump injection). The authors also examined the patient's general condition and blood concentration of drugs. RESULTS: The visual analog values were 44.8 /- 3.6, 26.7 /- 3.5, and 11.9 /- 3.1 mm in each period, respectively. The value in the PCA pump infusion period was significantly lower than that in the other periods. No side effects of the local anesthetics were observed on the patient's systemic condition. CONCLUSIONS: The authors controlled trigeminal neuralgia pain by blocking the mandibular nerve with local anesthetics administered through an indwelling catheter. Because the continuous nerve block with local anesthetics is reversible and only mildly toxic, this method is beneficial for pain control in patients with trigeminal neuralgia scheduled to undergo microvascular decompression.
- - - - - - - - - -
ranking = 0.66484111776711
keywords = nerve block, block
(Clic here for more details about this article)

4/19. A case of trigeminal-vagal neuralgia relieved by peripheral self-stimulation.

    A case of simultaneous trigeminal and vagoglossopharyngeal neuralgia is described. No microvascular compression was seen at the trigeminal complex while the origin of vagoglossopharyngeal pain could have been due either to Chiari malformation or microvascular compression of the IX-X nerve complex. Decompressive surgery was ineffective. The patient could completely block his facial painful fits by strongly pinching the anterior axillary fold. This case militates against peripheral theories of facial neuralgias, including microvascular compression and ganglion ignition focus theories, and supports a central origin thereof.
- - - - - - - - - -
ranking = 0.0010953293397341
keywords = block
(Clic here for more details about this article)

5/19. Repositioning of the vertebral artery with titanium bone fixation plate for trigeminal neuralgia.

    BACKGROUND: trigeminal neuralgia is usually treated by the padding method using Teflon felt. However this can not be done in certain cases in whom a large tortuous vertebrobasilar artery compresses the fifth nerve. The transposition method using the sling may be an alternative method. But this method is not an easy procedure and requires a relatively large craniotomy. Two cases were treated by a new and simpler effective technique. CLINICAL PRESENTATION: Two cases of the trigeminal neruralgia were treated. The first case was a 71 year-old male and the second case was a 63 year-old male. The history of the medical treatments were similar and both cases had had trigeminal nerve blocks and were prescribed carbamazepin. However, the pain control was insufficient in both cases. In both cases, three dimensional computerized tomography showed the large tortuous right vertebral artery ran just behind the clivus and compressed the right trigeminal nerve. In the second case past history showed a recent hypertensive cerebellar hemorrhage. TECHNIQUE AND RESULTS: A right suboccipital craniotomy were performed in both cases. In both cases, the right vertebral artery compressed the trigeminal nerve in a rostral direction. The sling technique with nylon sutures was tried in both cases but failed during surgery. Then, the bone fixation stainless plate was cut to 10 cm in length and pre-shaped with pliers. After being shaped, the distal end of the plate was inserted between the vertebral artery and fifth nerve and the proximal end of the plate was fixed to the skull by screw. The fifth nerve was completely isolated from the artery as they were in direct contact. After surgery, the pain disappeared completely during the follow-up of one and a half year in the first case and 9 months in the second case. CONCLUSION: The plate can be bent and curved with plier to suit each individual case. This technique is easily applied even when the slings or other isolation technique is not available and appeared to achieve the mechanically stronger reposition and fixation of a very large and tortuous artery away from the trigeminal nerve.
- - - - - - - - - -
ranking = 0.16593644710684
keywords = nerve block, block
(Clic here for more details about this article)

6/19. Surgical emphysema and Collet-Sicard syndrome after cryoblockade of the inferior alveolar nerve.

    We present a case of Collet-Sicard syndrome (palsy of cranial nerves IX-XII) together with cervicofacial emphysema after cryoblockade to the mandibular division of the trigeminal nerve.
- - - - - - - - - -
ranking = 0.0054766466986703
keywords = block
(Clic here for more details about this article)

7/19. trigeminal neuralgia in a patient with a dural arteriovenous fistula in Meckel's cave: case report.

    OBJECTIVE AND IMPORTANCE: trigeminal neuralgia is often the result of vascular compression at the root entry zone of the trigeminal nerve. We report a case of trigeminal neuralgia in a patient with a dural arteriovenous fistula in Meckel's cave. Endovascular closure of the fistula resulted in elimination of the patient's pain at the gasserian ganglion level. CLINICAL PRESENTATION: A 77-year-old woman was referred for treatment of trigeminal neuralgia after failed conservative treatment, including multiple gasserian ganglion blocks. magnetic resonance imaging of the brain suggested a vascular lesion, and cerebral angiography demonstrated a dural arteriovenous fistula in Meckel's cave. INTERVENTION: Endovascular coil embolization was performed, with obliteration of the dural arteriovenous fistula and resolution of facial pain but with decreased sensation in the face. CONCLUSION: trigeminal neuralgia may be associated with complex vascular lesions around the base of the brain and along the course of the trigeminal nerve. The evaluation of patients with trigeminal neuralgia should include high-quality, thin-section, magnetic resonance imaging scans, to exclude the possibility of vascular lesions and other structural lesions. In particular, patients who are being evaluated for surgical treatment of trigeminal neuralgia should undergo magnetic resonance imaging, with a focus on the course of the trigeminal nerve.
- - - - - - - - - -
ranking = 0.0010953293397341
keywords = block
(Clic here for more details about this article)

8/19. Pain relief by stellate ganglion block in a case with trigeminal neuralgia caused by a cerebellopontine angle tumor.

    A 29-year-old woman with symptoms suggestive of trigeminal neuralgia is presented. Because of her age, an intracranial tumor was suspected, but images of a brain computerized tomography scan revealed nothing in particular. A magnetic resonance imaging was scheduled 2 weeks later. However, as the pain increased and occurred more frequently, the patient returned to the hospital 2 days later. After a stellate ganglion block with transient nausea and dizziness, the pain was noticeably relieved. Using magnetic resonance scanning, a tumor in the cerebellopontine angle was discovered, and at surgical resection was diagnosed as an epidermoid tumor. stellate ganglion block may provide pain relief to some patients who are suspected to have symptomatic trigeminal neuralgia.
- - - - - - - - - -
ranking = 0.0065719760384044
keywords = block
(Clic here for more details about this article)

9/19. injections of botulinum toxin type a produce pain alleviation in intractable trigeminal neuralgia.

    To report the effects of local injections of botulinum toxin type A regarding pain relief and long-term control in a patient with intractable trigeminal neuralgia. The patient was a 75-year-old man with trigeminal neuralgia in the left hemifacial region. His pain was unbearable and could not be controlled by carbamazepine, amitriptyline, or blocked by infiltration of a glycerol solution or phenol. The authors evaluated pain intensity, quality, and location using a visual analog scale to establish the efficacy of botulinum toxin type A injections. Two units of botulinum toxin type A (Botox) were subcutaneously injected once in eight points distributed along the territory of V1 and V2. Visual Analog Scores were measured at baseline and at 7, 30, 60, and 90 days after treatment. The authors also examined the patient's general condition and daily life activities. The Visual Analog values were, respectively, 82, 54, 25, 25, and 45 mm at each follow-up examination. No side effects were observed on the site of injection and on the patient's clinical state. The authors have been able to reduce trigeminal neuralgia pain with botulinum toxin type A injections in the V1, V2 territory during all the period of study, as well as to withdraw all medication. Interestingly, there was concomitant reduction of pain also in V3, which was not injected.
- - - - - - - - - -
ranking = 0.0010953293397341
keywords = block
(Clic here for more details about this article)

10/19. Neurogenic pulmonary edema after trigeminal nerve blockade.

    Acute neurogenic pulmonary edema developed immediately after injection of bupivacaine hydrochloride into the trigeminal cistern of a 32-year-old man with atypical facial pain and no prior history of cardiopulmonary problems. This complication of trigeminal nerve blockade has not been reported previously, to our knowledge. Associated neurologic deficits suggest a key role for the brain stem in the pathogenesis of this disorder.
- - - - - - - - - -
ranking = 0.82968223553422
keywords = nerve block, block
(Clic here for more details about this article)
| Next ->


Leave a message about 'Trigeminal Neuralgia'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.