• Title/Summary/Keyword: 삼차신경통

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Clinical Considerations of Trigeminal Neuralgia (삼차신경통 진단 및 치료의 중요 고려사항)

  • Jeon, Young-Mi;Tae, Il-Ho;Choi, Jong-Hoon;Ahn, Hyung-Joon;Shim, Woo-Hyun;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.449-453
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    • 2007
  • Trigeminal neuralgia is defined as "a sudden, usually unilateral, brief stabbing recurrent pain in the distribution of one or more branches of the fifth cranial nerve" by the International Association for the Study of Pain(IASP). Trigeminal neuralgia is classified as an idiopathic trigeminal neuralgia with no apparent cause and a symptomatic trigeminal neuralgia which is caused by a structural lesion such as brain tumor. Over 80% of the tumors are meningioma, acoustic neuroma, and epidermoid tumors. Symptomatic trigeminal neuralgia can not be excluded even if old-aged patient does not have abnormal neurologic sign and symptom, and good response to pharmacotherapy. Therefore, initial examinations such as MRI or CT are essential to exclude symptomatic trigeminal neuralgia. When compared with CT, MRI, especially gadolinium enhanced MRI, has an increased sensitivity in the detection of intracranial lesions. The most effective medical treatment of trigeminal neuralgia is carbamazepine. The most common side effects of carbamazepine include drowsiness, dizziness, unsteadiness, nausea, anorexia. Hepatotoxicity, bone marrow depression are the most feared side effect of carbamazepine therapy but occurs rarely. It require periodic complete blood cell counts as well as hepatic and renal function tests. It has been recommended that complete blood cell counts is done every 2 weeks for the first 2months and then quaterly thereafter. Oxcarbazepine can be used if neutropenia occurs.

Linear Accelerator Radiosurgery for Trigeminal Neuralgia: Case Report (선형가속기를 이용한 삼차신경통의 정위적 방사선수술: 증례보고)

  • Yun Hyong-Geun
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.144-148
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    • 2006
  • Trigeminal neuralgia is defined as an episodic electrical shock-like sensation in a dermatomal distribution of the trigeminal nerve. When medications fail to control pain, various procedures are used to attempt to control refractory pain. Of available procedures, stereotactic radiosurgery is the least invasive procedure and has been demonstrated to produce significant pain relief with minimal side effects. Recently, linear accelerators were introduced as a tool for radiosurgery of trigeminal neuralgia beneath the already accepted gamma unit. Author have experienced one case with trigeminal neuralgia treated with linear accelerator. The patient was treated with 85 Gy by means of 5 mm collimator directed to trigeminal nerve root entry zone. The patient obtained pain free without medication at 20 days after the procedure and remain pain free at 6 months after the procedure. He didn't experience facial numbness or other side effects.

Treatment Pattern of Patients with Neuropathic Pain in Korea (한국인 신경병성 동통 환자의 치료 양태 연구)

  • Han, Sung-Hee;Lee, Ki-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.197-205
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    • 2009
  • The purpose of this study was to investigate the treatment pattern of patients with neuropathic pain (NeP) in Korea through computerized database of Health Insurance Review and Assessment Service (HIRAS) over three years' period from 2003 to 2005. The results showed that the numbers of treatment visits were the highest for diabetic neuropathy (DN), followed by postherpetic neuralgia (PHN) and trigeminal neuralgia (TN) in order. Top 3 specialties for treatment visits due to NeP conditions were neurology, neurosurgery and anesthesiology. While cost of a treatment visit was higher in anesthesiology and emergency clinics compared to other clinics, there was a tendency to increase costs for visits to clinics of rehabilitation medicine and family medicine over the three years. Cost of dental visits was relatively high for TN, atypical facial pain (AFP) and atypical odontalgia (AO). Surgeries frequently applied to patients with NeP were sympathetic plexus or ganglion block, block of peripheral branch of spinal nerve and cranial nerve or its peripheral branch block. Most common prescribed medication were anticonvulsants, anti-inflammatory analgesics and anti-psychotic drugs while anti-inflammatory analgesics were overwhelmingly frequently prescribed for AO and glossodynia. Based on the results of this study, NeP disorders more relevant to dentists were AO, TN and AFP, TN of which seems to be the most important in terms of patients' number and cost for treatment visits. This indicates that dentists, especially oral medicine specialists should actively participate in management of TN, AO and AFP and share relevant information with patients and community.

Epidemiology Study of Patients with Neuropathic Pain in Korea (한국의 신경병성 동통 환자에 대한 역학조사)

  • Won, Jung-Yeon;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.353-374
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    • 2008
  • The descriptive epidemiology of specific neuropathic pain disorders has not been well-des-cribed, although the burden of neuropathic pain is well recognized. The true incidence of neuro-pathic pain disorder is unknown, but it is believed to be under diagnosed and treated inade-quately, despite the development of various diagnostic system. The purpose of this study was to report the epidemiology of specific neuropathic pain as managed by all kinds of hospital in Korea. A descriptive analysis of the epidemiology of prevalent trigeminal neuralgia(TN)(n-=77,053 27,6%), atypical facial pain(AFP)(n=12,382 4.4%), glossopharyngeal neuralgia(GN)-(n=1,319 0.5%), post-herpetic neuralgia(PHN)-(n=84,598 30.3%), diabetic neuropathy(DN)-(n=85,989 30.8%), atypical odontalgia(AO)-(n=16,001 5.7%) and glossodynia(GD)(n=2,133 0.8%) and treatment departments and treatment durations from computerized Health Insurance Review and Assessment Service(HIRA) of Korea: January 2003 to December 2005, are reported with rates increasing over time for PHN and DN and decreasing for the other neuropathic pain disorders. Most patients were treated at private clinic record for 57.6-72.8% of patients except OA for 10.3%. The percentage of Dept of dentistry for outpatients was 3.2% for TN, 34.7% for AO and 15.4% for GD. Other neuropathic pain patients visited nearly medical clinic.

Alcohol Neurolysis for the Treatment of Trigeminal Neuralgia (Alcohol Neurolysis를 이용한 삼차 신경통 치험예)

  • Choe, Huhn
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.45-48
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    • 1989
  • Trigeminal neuralgia is one of the diseases which cause most chronic and intractable pain on the facial area. Several drugs includding analgegics, anticonvulsants, tranquilizers, vitamins or hormonal preparations have been expected to be effective but no drug could effectively relieve the patients from the pain. The pain could be relieved by surgical neurectomy or neurolysis of the Gasserian ganglion or the involved branches with absolute alcohol alternatively. Surgical microvascular decompression may be performed if the pain resulted from compression of the nerve by adjucent arterial loops. 4 cases of trigeminal neuralgia are presented. They were treated with alcohol neurolysis of the involved peripheral nerves combined with or without carbamazepine and/or amitriptyline with favorable result of pain relief.

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