• 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.

• Journal of Korean Neurosurgical Society
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• v.47 no.4
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• pp.271-277
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• 2010

Objective : The purpose of this study is to evaluate the clinical characteristics and surgical outcome of cerebellopontine angle (CPA) epidermoids presenting with trigeminal neuralgia. Methods : Between 1996 and 2004, 10 patients with typical symptoms of trigeminal neuralgia were found to have cerebellopontine angle epidermoids and treated surgically at our hospital. We retrospectively analyzed the clinico-radiological records of the patients. Results : Total resection was done in 6 patients (60%). Surgical removal of tumor and microvascular decompression of the trigeminal nerve were performed simultaneously in one case. One patient died due to postoperative aseptic meningitis. The others showed total relief from pain. During follow-up, no patients experienced recurrence of their trigeminal neuralgia (TN). Conclusion : The clinical features of TN from CPA epidermoids are characterized by symptom onset at a younger age compared to TN from vascular causes. In addition to removal of the tumor, the possibility of vascular compression at the root entry zone of the trigeminal nerve should be kept in mind. If it exists, a microvascular decompression (MVD) should be performed. Recurrence of tumor is rare in both total and subtotal removal cases, but long-term follow-up is required.

• Restorative Dentistry and Endodontics
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• v.22 no.2
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• pp.782-791
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• 1997

Glial fibrillary acidic protein(GFAP) are a group of intermediate filaments that are distributed in the cytoplasm of many type of glial cells. The purpose of this study was to determine change of GFAP immunoreactivity(GFAP-IR) in rat trigeminal ganglion satellite cells in response to pulp exposure. The immunohistochemistry was carried out using the avidinbiotin-peroxidase complex(ABC) method and subsequently stained with AEC(3-aminoethyl-9-carbasol). 1. Contol group; Central root astrocytes had strong GFAP-IR, but ganglion satellite cells occasionlly had GFAP-IR. This reaction patterns of ganglion satellite cells was not concenturated in any specific region of trigeminal ganglion. 2. Three day pulp exposure group; There was a highly GFAP-IR in satellite cells of trigeminal ganglion in maxillary region. GFAP-IR in neighboring mandibular and ophthalmic regions was less intense compared to maxillary region. 3. Seven day pulp exposure group; In this group, GFAP-IR that was increased compared to control group was seen in the maxillary region. But GFAP-IR was less intense compared to three day pulp exposure group. These results suggest that GFAP in satellite cell increase in specific region of trigeminal ganglion after pulp exposure and offer useful tool in trigeminal pain research.

• International Journal of Oral Biology
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• v.35 no.3
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• pp.75-81
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• 2010

The present study investigated the role of ERK in the onset of mechanical and cold allodynia in a rat model of compression of the trigeminal ganglion by examining changes in the air-puff thresholds and number of scratches following the intracisternal injection of PD98059, a MEK inhibitor. Male Sprague Dawley rats weighing between 250 and 260 g were used. Under anesthesia, the rats were mounted onto a stereotaxic frame and received 4% agar ($10\;{\mu}l$) solution to compress the trigeminal ganglion. In the control group, the animals were given a sham operation without the application of agar. Changes in behavior were examined at 3 days before and at 3, 7, 10, 14, 17, 21, 24, 30, and 40 days after surgery. Compression of the trigeminal ganglion significantly decreased the air-puff thresholds. Mechanical allodynia was established within 3 days and persisted over postoperative day 24. To evaluate cold allodynia, nociceptive scratching behavior was monitored after acetone application on the vibrissa pad of the rats. Compression of the trigeminal ganglion was found to produce significant cold allodynia, which persisted for more than 40 days after surgery. On postoperative day 14, the intracisternal administration of $1\;{\mu}g$ or $10\;{\mu}g$ of PD98059 in the rat model significantly decreased the air-puff thresholds on both the ipsilateral and contralateral side. The intracisternal administration of $10\;{\mu}g$ of PD98059 also significantly alleviated the cold allodynia, compared with the vehicle-treated group. These results suggest that central ERK plays an important role in the development of mechanical and cold allodynia in rats with compression of the trigeminal ganglion and that a targeted blockade of this pathway is a potential future treatment strategy for trigeminal neuralgia-like nociception.

• 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.

• The Journal of Korean Obstetrics and Gynecology
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• v.18 no.3
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• pp.234-241
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• 2005

Purpose : Trigeminal neuralgia has been known a rebellious disease and there has been no case report of trigeminal neuralgia during pregnancy in Oriental medicine. Experienced good effect on treatment for trigeminal neuralgia during pregnancy, we wanted to report a case report of trigeminal neuralgia during pregnancy. Methods : 5-month-pregnancy, patient with trigeminal neuralgia was hosptalized from the 10th, June, 2003 to the 23th, June, 2003 in OO Oriental Medical Center. In acupuncture therapy, SI19(Tinggong, 聽宮), S7(Hagwan, 下關), LI19(Hwaryo, 禾?), S4(Chichang, 地倉), S2(Sabaek, 四白), Tel7(Yepung, ?風), B2(Chanjuk, ?竹), G１4(Yangbaek, 陽白), 太陽(taeyang), 魚腰(yuje) were used. In Moxa Therapy, SI19(Tinggong, 聽宮), S7(Hagwan, 下關), LI19(Hwaryo, 禾?), S4(Chichang, 地倉), S2(Sabaek, 四白), Te17(Yepung, ?風) were used. In Herbal Therapy, Boikyangwytang was used. Pain was measured by VAS(Visual Analogue Scale). Results : At the 10th, June, 2003, Pain was measured VAS(100). At the 23th, June, 2003, Pain was measured VAS(10) and Pain was resolved, Tic(intermediate) was remain. Conclusion : We could get effective result that a case of trigeminal neuralgia during pregnancy, was treated conservative therapy of oriental medicine.

• The Korean Journal of Pain
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• v.5 no.1
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• pp.76-79
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• 1992

Trigeminal neuralgia is a condition characterized by excruciating paroxysms of pain in lips, gums, cheek, or chin, and very rarely, in the distribution of the ophthalmic division of the trigeminal nerve. There are many treatments of trigeminal neuralgia, such as, medical treatment, electrical stimulation, radiation therapy and ablative procedures. Infraorbital nerve block with pure ethyl alcohol is an ablation procedure for trigeminal neuralgia. We injected pure ethyl alcohol into the infraorbital foramen for pain control. The results were as follows; 1) The infraorbital nerve block with pure alcohol was an a simple and an effective method. 2) Complication, included a mild sensory deficit and mild edema over the infraorbital area.

• The Korean Journal of Physiology
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• v.28 no.1
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• pp.105-111
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• 1994

The present study was carried out to determine the effects of intracisternal administration of three doses of bombesin $(0.001,\;0.01\;and\;0.1\;{\mu}g)$ on afferent somatosensory transmission in single neurons of the spinal trigeminal nucleus of anesthetized rats. Lower doses $(0.001\;{\mu}g)$ of bombegin did not change the afferent sensory transmission. Medium doses $(0.01\;{\mu}g)$ of bombesin significantly (p p<0.01) facilitated afferent sensory transmission in the 6 to 30 min post-drug period, but higher doses $(0.1\;{\mu}g)$ inhibited responsiveness of spinal trigeminal neurons in the 16 to 35 min post-drug period. The results indicate that endogenous bombesin-like peptide present in the spinal trigeminal nucleus may participate in the processing of the somatosensory information arising from the face.

• Proceedings of the KACD Conference
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• 2001.11a
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• pp.581.1-581
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• 2001

Trigeminal nerve functions movement and sensation on orofacial region. Therefore, it is very important in dental clinic. Neurons with their cell bodies in trigeminal ganglion of trigeminal nerve root are primary sensory neurons and playa role of tactile sense, pressure, vibration and pain of orofacial area. Transmission of these senses depends on ion channels, we know that trigeminal ganglion neuron exists many kind of ion channels. Methods of definition on ion channel are several, but in this study we use immunostaining for detection of ion channels.(omitted)

• Journal of Oriental Neuropsychiatry
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• v.16 no.1
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• pp.221-226
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• 2005

The trigeminal neuralgia whose pain is led repeatedly and fitfully is limited inside the trigeminal nervous territory. The cause reveals so far clearly from the western medicine. According to this cause, the treatment is divided into surgical and non-surgical method. But the reduction of pain is not certificate and the case which concurs a sequela is many. So we made up to control typical primary trigeminal neuralgia by oriental medicine treatment like Herb Medication and A-Tx. In this case, patient is diagnosed 'Fire from stagnation of liver and stomach'(肝胃實熱)based on several symptoms. According to this, we used herbal medicine-chungpyesagantang-, and these efforts helped the case of disease.