• Title/Summary/Keyword: trigeminal neuralgia

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Lipoma Causing Glossopharyngeal Neuralgia : A Case Report and Review of Literature

  • Choi, Mi Sun;Kim, Young Im;Ahn, Young Hwan
    • Journal of Korean Neurosurgical Society
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    • v.56 no.2
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    • pp.149-151
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    • 2014
  • The cerebello-pontine angle lipomas causing trigeminal neuralgia or hemifacial spasm are rare. A lipoma causing glossopharyngel neuralgia is also very rare. A 46-year-old woman complained of 2-year history of severe right throat pain, with ipsilateral episodic otalgic pain. The throat pain was described as an episodic lancinating character confined to the throat. Computed tomography and magnetic resonance imaging revealed a suspicious offending posterior inferior cerebellar artery (PICA) compressing lower cranial nerves including glossopharyngeal nerve. At surgery, a soft, yellowish mass ($2{\times}3{\times}3mm$ in size) was found incorporating the lateral aspect of proximal portion of 9th and 10th cranial nerves. Only microvascular decompression of the offending PICA was performed. Additional procedure was not performed. Her severe lancinating pain remained unchanged, immediate postoperatively. The neuralgic pain disappeared over a period of several weeks. In this particular patient with a fatty neurovascular lump causing glossopharyngeal neuralgia, microvascular decompression of offending vessel alone was enough to control the neuralgic pain.

Early Therapeutic Effects of Cyberknife Radiosurgery on Trigeminal Neuralgia (삼차신경통에 대한 사이버나이프 방사선수술의 조기 치료 효과)

  • Mun Seong-Kwon;Choi Ihl-Bohng;Kang Young-Nam;Jang Ji-Sun;Kang Ki-Mun;Choi Byung-Ock
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.88-95
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    • 2006
  • Purpose: We evaluated whether Cyberknife radiosurgery is an effective and safe method of therapy for medically intractable trigeminal neuralgia (TN). Materials and Methods: We retrospectively analyzed the outcome of 26 patients, who failed to surgery or were not suitable candidates for invasive intervention and were treated by Cyberknife radiosurgery between March 2004 and May 2005. Radiosurgery doses of $60{\sim}64 Gy$ were delivered to the 80% isodose line prescribed to an 6 mm length of the nerve, sparing the most proximal 3 mm away from the trigeminal nerve root entry zone (median dose: 64 Gy). Results: Follow-up period was $3{\sim}15$ months (median follow-up period: 9 months) Preliminary results from a cohort of 26 patients undergoing Cyberknife radiosurgery for TN showed that pain relief was achieved in 50% (13/26) of patients within the first 24 hrs after treatment. At last follow-up, 96.2% (25/26) of patients reported early pain relief within 7 days. Treatment failure developed in 2 of 26. Poor response occurred in one patient and relapse was observed in the other patient. 3 patients had hypoesthesia (11.5%), which was the only complication observed with any of our patients. Conclusion: With these results, authors assumed that Cyberknife radiosurgery for TN could be one of safe and effective therapeutic methods.

Alveolar bone necrosis and spontaneous tooth exfoliation associated with trigeminal herpes zoster: a report of three cases

  • Kim, Nam-Kyoo;Kim, Bong-Chul;Nam, Jung-Woo;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.3
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    • pp.177-183
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    • 2012
  • Herpes zoster is a viral infection caused by the reactivation of the varicella zoster virus, an infection most commonly affecting the thoracolumbar trunk. Herpes Zoster Infection (HZI) may affect the cranial nerves, most frequently the trigeminal. HZI of the trigeminal nerve distribution network manifests as multiple, painful vesicular eruptions of the skin and mucosa which are innervated by the infected nerves. Oral vesicles usually appear after the skin manifestations. The vesicles rupture and coalesce, leaving mucosal erosions without subsequent scarring in most cases. The worst complication of HZI is post-herpetic neuralgia; other complications include facial scarring, motor nerve palsy and optic neuropathy. Osteonecrosis with spontaneous exfoliation of the teeth is an uncommon complication associated with HZI of the trigeminal nerve. We report several cases of osteomyelitis appearing on the mandible, caused by HZI, and triggering osteonecrosis or spontaneous tooth exfoliation.

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.

HERPES ZOSTER WITH ORAL LESION; CASE REPORT AND REVIEW OF CURRENT LITERATURE (구강 내 병소를 동반한 대상 포진에 관한 증례 보고 및 최신 문헌 고찰)

  • Kim, Ki-Young;Kim, Jong-Sik;Kim, Hyung-Wook;Hong, Soon-Min;Park, Jun-Woo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.3
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    • pp.268-272
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    • 2007
  • Herpes zoster is caused when the varicella zoster virus(VZV) that has remained latent since an earlier varicella infection is reactivated with cutaneous and mucous manifestations. They occur in 20% cases in the trigeminal area and typical manifestations are neuralgias simulating dental pain, also vesicles with an erythematous halo located in the territory of the second and third trigemial branch. They erupt on the skin, the lips, tongue, palate and cheeks. With an ever-increasing number of elderly and immunocompromised patients attending the dentist, the dental profession can expect to encounter an increased number of herpes zoster patients. Furthermore, the oral and maxillofacial surgeons must be familiar with the presenting signs and symptoms of patients experiencing the prodromal manifestations and oral complication of herpes zoster of the trigeminal nerve. As presentation of our patient with ulcer on hard palate caused by herpes zoster, current treatment of herpes zoster and post-herpetic neuralgia are discussed.

The Literature Study on Medical treatments with acupuncture for "Trigeminal neuralgia" (삼차신경통(三叉神經痛)의 치료혈(治療穴)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Lyu, Eun-sang;Lee, Hyun;Lee, Byung-ryul
    • Journal of Haehwa Medicine
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    • v.10 no.1
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    • pp.259-268
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    • 2001
  • As mentioned above, I have acquired some valuable results about medical treatments with acupuncture for "Trigeminal neuralgia" after studying oriental medical books. 1. The course of medical treatments with acupuncture was, first of all, applying general ones, and then, assisting ones based on occuring area of pain and the cause. 2. For general treatments, "Chok-yangmyong-Wi-Kyong", distributed widely on the face, was used in great numbers. The order, according to the number of using times, of spots for acupuncture was Ha-kwan(11 times), Hap-kok(10), Chan-juk(7), Hyop-geo, Tae-yang, Sa-baek(individually 6). 3. For assisting treaments based on occuring area of the pain, spots of the Kyong-rak, passing through occuring area of the pain, and Kyong-woe-ki-hyol were used in great numbers. 4. The order was O-je, Chan-juk, Yang-baek(individually 8), Tae-yang(5) for the pain of first branch of the trigeminal nerve; Sa-baek(12), Kwan-ryo(6), Go-ryo(5) for the pain of second one; and Hyop-geo, Ha-kwan(individually 6), Dae-young, Hyop-seung-jang(individually 5). Seung-jang(4). 5. For assisting treatments based on the cause, "One-hyol(原穴)", "Rak-hyol(絡穴)" and "5-soohyol(五輸穴)" were used in great numbers. 6. The order was Pung-ji(10), Hap-kok(9), Woe-kwan(5) for "Woe-Kam(外感)"; Nae-jong(12), Tae-chung(10), Chok-sam-ri(7) for "Kan-Wi-Hwa-Seung(肝胃火升)"; Tae-gue(7), Sam-um-kyo, Pung-ji(individually 2) for "Ho-Hwa-Sang-Seung(虛火上升)"; Pung-ryung(4) for "Pung Dam-Jo-R ak (風痰阻絡)"; Kyok-su(2) for "Ki-Che-Hyol-Ho(氣滯血虛)".

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New insight into the mandibular nerve at the foramen ovale level for percutaneous radiofrequency thermocoagulation

  • Peng-Bo Zhu;Yeon-Dong Kim;Ha Yeong Jeong;Miyoung Yang;Hyung-Sun Won
    • The Korean Journal of Pain
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    • v.36 no.4
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    • pp.465-472
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    • 2023
  • Background: Percutaneous radiofrequency thermocoagulation (RFTC) has been widely utilized in the management of trigeminal neuralgia. Despite using image guidance, accurate needle positioning into the target area still remains a critical element for achieving a successful outcome. This study was performed to precisely clarify the anatomical information required to ensure that the electrode tip is placed on the sensory component of the mandibular nerve (MN) at the foramen ovale (FO) level. Methods: The study used 50 hemi-half heads from 26 South Korean adult cadavers. Results: The cross-sectioned anterior and posterior divisions of the MN at the FO level could be distinguished based on an irregular boundary and color difference. The anterior division was clearly brighter than the posterior one. The anterior division of the MN at the FO level was located at the whole anterior (38.0%), anteromedial (6.0%), anterior center (8.0%), and anterolateral (22.0%) parts. The posterior division was often located at the whole posterior or posterolateral parts of the MN at the FO level. The anterior divisions covered the whole MN except for the medial half of the posterolateral part in the overwrapped images of the cross-sectional areas of the MN at the FO level. The cross-sectional areas of the anterior divisions were similar in males and females, whereas those of the posterior divisions were significantly larger in males (P = 0.004). Conclusions: The obtained anatomical information is expected to help physicians reduce unwanted side effects after percutaneous RFTC within the FO for the MN.

Clinical Diagnosis and Treatment of Herpes Zoster in an Immunocompromised Dental Patient: A Case Report

  • Kim, Hyun-Suk;Ahn, Kyo-Jin;Kim, Young-Kyun
    • Journal of Korean Dental Science
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    • v.7 no.2
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    • pp.99-105
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    • 2014
  • Herpes zoster (HZ) is an acute, unilateral inflammatory viral infection characterized by a rash with painful blisters in a localized area of the body. HZ is often associated with intense pain in the acute phase and presents postherpetic neuralgia in the chronic phase. During the prodromal stage of the HZ from the trigeminal nerve, however, the only presenting symptom may be odontalgia, which could be particularly difficult to diagnose. This distinctive syndrome occurs predominantly in the immunocompromised or elderly individuals. In this article, we report a case of HZ developed in the trigeminal nerve of a 60-year-old immunocompromised female patient, whose symptoms including atypical, non-odontogenic odontalgia had improved after series of antiviral treatments.