• The Korean Journal of Pain
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• v.13 no.2
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• pp.232-236
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• 2000

Bilateral trigeminal neuralgia is uncommon and usually occurs in 1% to 11% of patients with trigeminal neuralgia. There has been no report of a patient with bilateral trigeminal neuralgia in Korea. Based on our review, the incidence of bilateral trigeminal neuralgia among the trigeminal neuralgia patients who visited our pain clinic numbered 0.7% (4 out of 531). This is much lower than those of other previous studies. This lower incidence might be explained by the fact that we excluded those patients with mild bilateral trigeminal neuralgia which did not require treatment and also patients whose symptom on controlateral side was relieved by injection of local anesthetics for that side. Among the four patients with bilateral trigeminal neuralgia, three patients received alcohol block of the branches of trigeminal nerve and one refused the treatment. Overall, three patients maintained good or excellent pain relief without any serious complications throughout the follow-up period.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.640-651
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• 2022

Clinical studies on neuromodulation intervention for trigeminal neuralgia have not yet shown promising results. This might be due to the fact that the pathophysiology of chronic trigeminal neuropathy is not yet fully understood. Chronic trigeminal neuropathy includes trigeminal autonomic neuropathy, painful trigeminal neuropathy, and persistent idiopathic facial pain. This disorder is caused by complex abnormalities in the pain processing system, which is comprised of the affective, emotional, and sensory components, rather than mere abnormal sensation. Therefore, integrative understanding of the pain system is necessary for appropriate neuromodulation of chronic trigeminal neuropathy. The possible neuromodulation targets that participate in complex pain processing are as follows : the ventral posterior medial nucleus, periaqueductal gray, motor cortex, nucleus accumbens, subthalamic nucleus, globus pallidus internus, anterior cingulate cortex, hypothalamus, sphenopalatine ganglion, and occipital nerve. In conclusion, neuromodulation interventions for trigeminal neuralgia is yet to be elucidated; future advancements in this area are required.

• The Korean Journal of Pain
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• v.35 no.4
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• pp.383-390
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• 2022

Background: The treatment of trigeminal neuralgia remains a challenging issue. Stem cells from human exfoliated deciduous teeth (SHED) provide optimized therapy for chronic pain. This study aimed to investigate the mechanisms underlying the attenuation of trigeminal neuralgia by SHED. Methods: Trigeminal neuralgia was induced by chronic constriction injury of the infraorbital nerve. The mechanical threshold was assessed after model establishment and local SHED transplantation. Endoplasmic reticulum (ER) morphology and Caspase12 expression in trigeminal ganglion (TG) was evaluated as well. BiP expression was observed in PC12 cells induced by tunicamycin. Results: The local transplantation of SHED could relieve trigeminal neuralgia in rats. Further, transmission electron microscopy revealed swelling of the ER in rats with trigeminal neuralgia. Moreover, SHED inhibited the tunicamycin-induced up-regulated expression of BiP mRNA and protein in vitro. Additionally, SHED decreased the up-regulated expression of Caspase12 mRNA and protein in the TG of rats caused by trigeminal neuralgia after chronic constriction injury of the infraorbital nerve mode. Conclusions: This findings demonstrated that SHED could alleviate pain by relieving ER stress which provide potential basic evidence for clinical pain treatment.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.39-42
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• 1994

The purpose of this study was to review the results of the neurolytic trigeminal nerve block in 41 patients from April 1992 to March 1994. Most common site of trigeminal neuralgia was the second division(27 patients, 68.3%). Nineteen patients of these were treated with infraorbital nerve block. Another 4 patients had cerebello-pontine angle tumor close to TREZ in MRI findings therefore they were excluded from this study. Thirty nine patients (95.1%) remained free of pain. Only 2 patients treated with infraorbital nerve block experienced recurring pain. Although the follow-up period was short, alcohol blocks proved effective and safe for treatment of trigeminal neuralgia.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.11-15
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• 1997

Background : There are several treatment of trigeminal neuralgia including Gasserian Ganglion Block. This paper retrospectively analyze the efficacy of Gasserian Ganglion Block as main treatment of trigeminal neuralgia. Methods : We studied 55 patients for followings; sex, age, duration from onset to visit, consulted mediator, causes, characteristics of pain, affected area, types of block, kinds and volume of used neurolytic agents, duration from first block to repeat block, types of repeat block, complications, if surgery was necessary after block. Results : Characteristic items of trigeminal neuralgia are similar with other studies. Mean duration of pain relief was 23 months. The duration was shortened in the repeat block. There were no significant complication. Conclusion : Considering Gasserian Ganglion Block as main treatment of trigeminal neuralgia is an effective and safe method. Therefore we would like to recommend the need to increase public awareness of trigeminal neuralgia and its possible treatment in pain clinics through mass commanication.

• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.66-71
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• 2000

Objective : There are many treatment modalitis in management of idiopathic trigeminal neuralgia. In the secondary trigeminal neuralgia, there has been only sporadic reports of the etiology. Authors report the treatment result of secondary trigeminal neuralgia with percutaneous radiofrequency rhizotomy. Methods : During last ten years, 129 trigeminal neuralgias were treated by percutaneous radiofrequency(RF) rhizotomy by authors. Among them, nine patients were secondary trigeminal neuralgias. These patients refused treatment for the primary cause and only wanted pain control. The offending lesions were three arachnoid cysts, six tumors. The mean age was 47.8 years and the mean duration of follow-up was 6.2 years. The right V2,3 distribution was most prevalent area of pain. Authors used the conventional Hartel's anterior approach and straight electrode for RF lesion generation. Result : The early result was satisfactory. Eight of nine patients became free of pain and one patient needed minimal dose of carbamazepine. The overall pain control was 100%. There was no mortality or morbidity for initial RF rhizotomy. During follow-up, four patients showed recurrence of pain(44%). Among these, two underwent repeated RF rhizotomy and became free of pain. The other two were controlled with medical management. Conclusion : These results indicate that the percutaneous RF rhizotomy is effective means of pain control. Overall recurrence was somewhat higher than that of idiopathic trigeminal neuralgia. Even with recurrence, however, repeated RF rhizotomy seems to be effective method of control of pain in these cases.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.827-836
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• 2021

Objective : Trigeminal neuralgia is one of the most common causes of facial pain. Our aim is to investigate the efficacy and borders of percutaneous radiofrequency thermocoagulation in the treatment of trigeminal neuralgia. Methods : Between May 2007 and April 2017, 156 patients with trigeminal neuralgia were treated with radiofrequency thermocoagulation. These 156 patients underwent 209 procedures. In our study, we investigated the early and late results of percutaneous radiofrequency thermocoagulation under guiding fluoroscopic imaging in the treatment of trigeminal neuralgia. Barrow Neurological Institute (BNI) pain scale was used for grading the early results. In addition, Kaplan-Meier survival analysis was used to assess long-term outcomes. Of the 156 patients who underwent radiofrequency thermocoagulation for trigeminal neuralgia, 45 had additional disease. Patients with this condition were evaluated with their comorbidities. Early and late results were compared with those without comorbidity. Results : In 193 of 209 interventions BNI pain scale I to III results were obtained. Out of the 193 successful operation 136 patients (65.07%) were discharged as BNI I, 14 (6.70%) as BNI II, 43 (20.58%) as BNI III. Sixteen patients (7.65%) remained uncontrolled (BNI IV and V). While the treatment results of trigeminal neuralgia patients with comorbidity seem more successful in the early period, this difference was not observed in follow-up examinations. Conclusion : Finally, we concluded that percutaneous radiofrequency thermocoagulation of the Gasserian ganglion is a safe and effective method in the treatment of trigeminal neuralgia. However, over time, the effectiveness of the treatment decreases. Neverthless, the reapprability of this intervention gives it a distinct advantage.

• Korean Journal of Acupuncture
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• v.33 no.1
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• pp.37-45
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• 2016

Objectives : To understand spatial cause hypothesis of idiopathic trigeminal neuralgia, the body truncus area was divided into intracranial, thoracic and pelvic cavity and was illustrated, the subjective pain degrees of idiopathic trigeminal neuralgia were compared with the illustraion of three cavity. Methods : The frontal view of pictures of idiopathic trigeminal neuralgia subject truncus area were illustrated into three circles which was treated with conservative methods like the pelvic correction, cervical correction, FCST, posture training without drugs and acupuncture. The spatial analysis of three circle vertical centerlines were compared with the pain degrees. Results : The vertical centerlines of three circles were agreed with the body gravity centerline depending on the treatment progresses. namely, as the parts of truncus were matched to the body gravity centerline, the degrees of pain were decreased. Conclusions : The vascular pressure on the trigeminal nerve which was causing the idiopathic trigeminal neuralgia might be induced by the spatial misalignment of truncus area because the spatial misalignment of it can press to move vascular into trigeminal nerve partially. Further study will be progressed.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.261-265
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• 2001

Radiofrequency thermocoagulation of the gasserian ganglion is a safe procedure that can be controlled well and provides satisfactory pain relief from trigeminal neuralgia with low risk. Here the authors report a case of radiofrequency thermocoagulation performed on a recurred trigeminal neuralgia patient, with particular attention to the V3 area. The patient was treated with microvascular decompression 7 years previous, which lead to untolerable side effects from carbamazepine medication. Following the paresthesia and masseter muscle contracture test at 50 Hz-0.06 volt and 2 Hz-0.5 volt respectively, RF lesionings were performed for 60 sec at $60^{\circ}C$ and 70 sec at $70^{\circ}C$. One week after the procedure, the pain was reduced with a mild hypoesthesia in the V2 area. After 6 months, the pain recurred. Therefore, we performed the same procedure again. After 8-months of follow-up, there has been no pain or complications.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.13 no.2
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• pp.112-139
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• 2000

I examined and referred to literatures of every generations on the nicknames, causes, herb medications and acupucture treatments of ptosis(上胞下垂). And then the results were obtained as follows. We've compared and analyzed Occidental and Oriental medical causes, symptoms and treatments of Primary trigeminal neuralgia and wanted to get better effects by a cooperative analysis. So the examination and analysis of the recent treatment tendency and reference bibliography show the following results. 1. Trigeminal neuralgia is nerve systematic disease appearing in the distribution scope of trigeminal nerve. It's characterized by extreme pain accompanying with a repeated and simultaneous fit from several seconds to 1-2 minutes. 2. Though there are many hypothesis on the trigeminal neuralgia, but now many doctors agree that when trigeminal nerve is under the local out of sheath conditions resulting from receiving a chronic stimulus, and the nucleus of trigeminal nerve fire, owing to decrease of pain control function and abnormal occurrence of action potential, it would be appeared. 3. The Oriental medical name of trigeminal neuralgia is generally Dootong, Doopoong, Myuntong, Pyundootong, Pyundoopoong, and Myuntong is the nearest in Occidental medicine. 4. The Oriental medical cause of trigeminal neuralgia is usually divided into Wekam and Naesang. The first one is caused by Poonghan, Poongyul, Damhwa and wicked energy enter into the body, the mechanical energy is obstructed and can't move any more, so the pain appears by them. The other cause is the hurt by emotion. And it would be loss of the transportain of liver and obstructed, so result into Kanwulhwahwa, Kanpoongnaedong and the pain appears. 5. There are two methods of curing trigeminal neuralgia. As a medication, primary method is prescribing Carbamazepine and the second is using Phenytoin or Baclofen. And as a operation, Drug injection of trigeminal nerve, Amputation of branches of trigeminal nerve, Retrogasserian glycerol rhizotomy, Radiofrequency gangliolysis, Neurovascular decompression can be used. 6. There are several herb medicines for Trigeminal neuralgia. First, Chungung is good for Hwaejeetong, Keopoongjedam, Hwalhyuljeetong. Second, Jeongal, Jiryong, Okong is used for Sikpoonghekyung, Tongkyungjeetong. Third, Baekjee, Sesin, Cheonma, Manhyungja is efficacious in Sinonhepyo. Sanpoongjeetong. Fourth, for falling of liver's Wulhwa, Yongdamcho, Hyungge, Kukwha can be used. And also Saengjihwang, Hwangkm is good for going down the fever of Yangmyungwiyul and finally, Baekkangjam. Moryu can be effective for Jaumjamyang, Haekyungjitong. The other medicines can be used as assistant analgesics, and it also efficacious. 7. Generally the points of pain on the face and the points of Soyangkyung and Yangmyungkyung is used for Acupuntual therapy, because the two meridians passed on the face. Hakwan. Sabaek, Kwanryo, Keoryo, Hyubkeo, Taeyang, Jeechang, Younghyang, Eoyo, Chanjuk. Yangbaek. Sajukkong. Dooyoo, Kwangsangjum, Sengjang, Poongjee is used for taking near point and Joksamlee, Naejung, Habkok is used for taking distant point. 8. Dansam or Danggui injection which have a effect for Hwalhyulhwaeo, Sokyunghwalak and Vit B1, Vit B2, Vit B12, $2\%$ Hydrochloroprocaine, $1\%$ Lidocaine injection to pain point for local analgesics had so good effect. And external application and moxibustion are used for another treatment. 9. It proved that through mouse model, both Herb medication group and Drug medication group are efficacious for trigeminal neuralgia similarly and also the cooperative medication group shows more effective result than the only drug medication group.