• Title/Summary/Keyword: trigeminal

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Radiofrequency Thermocoagulation for Recurred Trigeminal Neuralgia -A case report- (고주파 열응고술을 이용한 재발한 삼차 신경통의 치료 경험 -증례 보고-)

  • Lim, Kyung-Joon;Lee, Jae-Chul;Kim, Seung-Soo
    • 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.

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The Clinical Observation on 1 Case of Patient with Herpes Zoster Infecting Ophthalmic Branch of Trigeminal Nerve (안구 대상포진환자 1례에 관한 증례보고)

  • 배성한;남창규
    • The Journal of Korean Medicine
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    • v.20 no.4
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    • pp.106-114
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    • 2000
  • The herpes zoster infecting ophthalmic branch of trigeminal Nerve that is similar to migraine at first stage symptom has been treated with oriental medication at Dept. of Internal Medicine, Semyung University Oriental Hospital. The fIrst symptom of roster is burning pain, tingling or extreme sensitivity in one area of the skin, usually limited to one side of the body. This may be present for one to three days before a red rash appears at that site. There may also be a fever or headache. The rash soon turns into groups of blisters. The blisters start out clear but then pus or dark blood collects in the blisters before they crust over (scab) and begin to disappear. The pain may last longer. In this case, the severe pain was present for five days, the blisters and scabsdisappeared entirely on the seventeenth day, but postherpetic neuralgia, the most common complication and is observed most frequently in the ophthalmic branch of trigeminal nerve, was not prevented entirely. We have observed this case and report to help treatment on this disease at oriental medicine clinic.

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Mandibular Nerve Block for Trigeminal Neuralgia -A case report- (삼차신경통 환자에서의 하악신경 차단 -1예 보고-)

  • Lim, Jae-Jin;Lee, Kwang-Ho;Kim, Chan
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.247-250
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    • 1993
  • Trigeminal neuralgia(tic douloureux) is a condition characterized by excruciating paroxysms of pain in lips, gums, cheek or chin. There are many treatments of trigeminal neuralgia, such as carbamazepine, electrical stimulation, radiation therapy and ablative procedures. We blocked the mandibular nerve via lateral extra-oral route with pure ethyl alcohol in patient with localized gingival pain. The results were as follows; 1) The mandibular nerve block with pure ethyl alcohol was effective. 2) No complications were noted.

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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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One case of Trigeminal neuralgia (三차神經痛 患者의 治驗 1例)

  • Kim Hong-Jin;Kim Jong-Han;Choi Jung-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.14 no.2
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    • pp.295-302
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    • 2001
  • Trigeminal neuralgia has a specific property which burning pain emerges suddenly and spasmodically. The following pain continuously emerges during 20 seconds or 30 seconds and then the pain disappears. This process of the pain emerges repeatedly. Trigeminal neuralgia was called Myuntong(麵痛). We experienced a patient who had Trigeminal neuralgia for five years. she was successfully treated by the herb-medication, accupunture and negative. The medication taken by the patient were Seunghyungsan(升荊散) and Jowyuseung chengtang(謂胃升淸湯) and so on. The accupunture was mainly done at mainly done G-14(陽白), S-2(瀉白), G-3(上關), S-36(足三里), LI-4(합閤穀) and so on. The negative was done sternocleidomastoid muscle, trapezius and Masseter muscle.

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Surgical Treatment for Trigeminal Neuralgia

  • Park, Chang Kyu;Park, Bong Jin
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.615-621
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    • 2022
  • Various treatments for trigeminal neuralgia (TN) are known to yield initial satisfactory results; however, the surgical treatment has excellent long-term outcomes and a low recurrence rate. Surgical treatment addresses the challenge of vascular compression, which accounts for 85% of the causes of TN. As for surgical treatment for TN, microvascular decompression (MVD) has become the surgical treatment of choice after Peter J. Jannetta reported the results of MVD surgery in 1996. Since then, many studies have reported a success rate of over 90% for the initial surgical treatment. Most MVDs aim to separate (decompress) the culprit vessel from the trigeminal nerve. To increase the success rate of surgery, accurate indications for MVD and management of the offender vessels without complications are critical. In addition, if there is no vascular compression, partial sensory rhizotomy or internal neurolysis can be performed to improve surgical outcomes.

An interesting case of survival to multiple ruptures of aneurysms, with persistent trigeminal artery, cranial nerve deficit, and evolutionary exposure of neurovascular treatment

  • Hector Lezcano;Maria Fernanda Solorzano
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.2
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    • pp.189-195
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    • 2023
  • Subarachnoid hemorrhage secondary to rupture of an aneurysm is a severe condition, associated with a high rate of morbidity and mortality. There are few cases in the literature of rupture of an aneurysm of the persistent trigeminal artery. This is the case of a 62-year-old female who has suffered multiple ruptures of aneurysms, in different decades of her life, with the development of de novo aneurysm, been this the presented case, a rupture of aneurysm of the persistent trigeminal artery. This patient has survival to these conditions and remain without important morbidity. The case manifested with a clinical picture of third and seventh cranial nerve deficit, which this last one, there are not previous publications of cases with this deficit. This aneurysm was embolized with coils, and the postoperative condition was satisfactory, been discharged at 4 postoperative days.

Anatomical Considerations in Gamma Knife Radiosurgery for Idiopathic Trigeminal Neuralgia

  • Kim, Young-Hoon;Park, Chul-Kee;Chung, Hyun-Tai;Paek, Sun-Ha;Kim, Dong-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.148-153
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    • 2006
  • Objective : The authors conducted this study to present the long-term treatment outcomes [minimum 2 years] of Gamma knife radiosurgery[GKS] for trigeminal neuralgia[TN] and to demonstrate the correlation of treatment outcomes and the anatomical characteristics of TN. Methods : From 1997 to 2003, 44 consecutive patients suffering from medically intractable pain underwent GKS for TN. A single 4mm collimator was used with a median maximum dose of 80Gy [range $75{\sim}80Gy$] prescribed to the root entry zone of the trigeminal nerve. Median follow up duration was 30 months [range $24{\sim}78\;months$]. Anatomical measurements of trigeminal nerve in magnetic resonance images during GKS planning were correlated with clinical outcome. Results : Twenty-two patients [50%] achieved an excellent outcome [BNI grade I & II], 20 patients [45.5%] a good outcome [grade IIIa & IIIb], and only 2 patients [4.5%] a poor outcome [grade IV & V]. Eleven patients [25.0%] experienced pain recurrence after initial pain relief. Smaller volume of trigeminal nerve area irradiated more than 40Gy was significantly correlated with excellent outcome in both univariate and multivariate analyses respectively [P=0.033 and 0.040]. Conclusion : Anatomical considerations during the planning of GKS would be helpful for predicting clinical outcome in TN.

EFFECTS OF MANDIBULAR NERVE TRANSECTION ON TRIGEMINAL GANGLION NEURONS AND THE ACTIVATION OF MICROGLIAL CELLS IN THE MEDULLARY DORSAL HORN (하악신경 절삭이 삼차신경절 신경세포와 연수후각 소교세포 활성화에 미치는 영향)

  • Lim, Yo-Han;Choie, Mok-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.3
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    • pp.227-237
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    • 2007
  • Microglial cell activation is known to contribute to neuropathic pain following spinal sensory nerve injuries. In this study, I investigated its mechanisms in the case of trigeminal sensory nerve injuries by which microglial cell and p38 mitogen-activated protein kinase (p38 MAPK) activation in the medullary dorsal horn (MDH) would contribute to the facial pain hypersensitivity following mandibular nerve transection (MNT). And also investigated the changes of trigeminal ganglion neurons and ERK, p38 MAPK manifestations. Activation of microglial cells was monitored at 1, 3, 7, 14, 28 and 60 day using immunohistochemical analyses. Microglial cell activation was primarily observed in the superficial laminae of the MDH. Microglial cell activation was initiated at postoperative 1 day, maximal at 3 day, maintained until 14 day and gradually reduced and returned to the basal level by 60 days after MNT. Pain hypersensitivity was also initiated and attenuated almost in parallel with microglial cell activation pattern. To investigate the contribution of the microglial cell activation to the pain hypersensitivity, minocycline, an inhibitor of microglial cell activation by means of p38 MAPK inhibition, was administered. Minocycline dose-dependently attenuated the development of the pain hypersensitivity in parallel with inhibition of microglial cell and p38 MAPK activation following MNT. Mandibular nerve transection induced the activation of ERK, but did not p38 MAPK in the trigeminal ganglion. These results suggest that microglial cell activation in the MDH and p38 MAPK activation in the hyperactive microglial cells play an important role in the development of facial neuropathic pain following MNT. The results also suggest that ERK activation in the trigeminal ganglion contributes microglial cell activation and facial neuropathic pain.

Review on Clinical Studies on Korean medicine Treatment for Trigeminal Neuralgia (삼차신경통의 한의학적 치료에 대한 국내 임상 연구 고찰)

  • Cha, Hyun Ji;Lee, Ye Ji;Kim, Hyo Bin;Kim, Beom Seok;Sung, Ki Jung;Lee, Young Rok;Choi, Kang Min;Kim, Jin Youp;Jeon, Ju Hyun;Kim, Eun Seok;Kim, Young Il
    • Journal of Haehwa Medicine
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    • v.29 no.2
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    • pp.12-21
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    • 2020
  • Objectives : The aim of this study is to review clinical studies on trigeminal neuralgia treatment through Korean Medicine. Methods : We used search engines such as KISS, RISS, KOREAMED and NDSL. We limited cases as idiopathic trigeminal neuralgia without comorbidities. We excluded dissertation. We considered papers published after year 2000. Results : Fourteen studies were searched for this study. Various treatments such as acupuncture therapy, herbal medicine, moxibustion therapy, manipulation, pharmocopuncture, vomiting therapy were practiced for trigeminal neuralgia. Conclusions : All study were case report and evidence level of the searched studies was not high. They reported meaningful improvement through Korean Medicine treatment and these studies implied effectiveness and safety of Korean Medicine for Trigeminal neuralgia.