• 제목/요약/키워드: trigeminal pain

검색결과 216건 처리시간 0.029초

Efficacy of medications in adult patients with trigeminal neuralgia compared to placebo intervention: a systematic review with meta-analyses

  • Peterson-Houle, Georgia M.;AbdelFattah, Magda R.;Padilla, Mariela;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권5호
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    • pp.379-396
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    • 2021
  • Background: Trigeminal neuralgia (TN) is characterized by brief, unilateral, sharp, stabbing, and shooting pain of the fifth cranial nerve. The objective of this systematic review with meta-analysis was to determine the effect of medications compared to placebo in adult patients with TN. Methods: Review authors identified randomized placebo-controlled trials (RCTs) from PubMed, Web of Science, Cochrane, and EMBASE up to February 2021. We assessed the inclusion and exclusion criteria as well as the risk of bias of the studies based on the Cochrane Handbook. A total of 324 unduplicated references were scanned independently and reduced to eight relevant RCTs, with 89 patients included. Medications investigated included oral carbamazepine, subcutaneous sumatriptan, lidocaine (intranasal, 8% spray on the oral mucosa or intravenous), buprenorphine (ganglionic local opioid analgesia), and oral Nav1.7, a selective sodium channel blocker. Results: Meta-analyses showed that overall patients receiving lidocaine reported a significantly lower post-treatment intensity of pain -3.8 points on a 0-10 scale (95% Cl = -4.653 to -2.873; P < 0.001). Patients who received lidocaine were 8.62 times more likely to have pain improvement than patients on placebo (P < 0.001). In one RCT, patients receiving oral carbamazepine showed a significant improvement in pain intensity of -32% compared to the placebo (P < 0.001). In one trial, patients receiving 3 mg subcutaneous sumatriptan had a significantly lower intensity of pain on average -6.1 points on a scale of 0-10 compared to placebo (P < 0.001) and a significant improvement in pain intensity of -75% compared to the improvement in the placebo group (P < 0.001). Patients who received subcutaneous sumatriptan were 10 times more likely to have pain improvement than those who received placebo (P = 0.001) in one study. Due to the unclear/high risk of bias and small sample size, the quality of the evidence for lidocaine in the treatment of TN was low. Conclusion: Further studies are needed for carbamazepine, sumatriptan, buprenorphine, and oral Nav1.7 sodium channel blockers, as only one study reported outcomes.

삼차신경통에 대한 봉약침을 병행한 한방치료 치험 1예 (A Case of Trigeminal Neuralgia Treated by Korean Medical Treatment Including Bee Venom Pharmacopuncture)

  • 양태준;이정훈;김선욱;정주용;위통순
    • Korean Journal of Acupuncture
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    • 제31권4호
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    • pp.225-228
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    • 2014
  • Objectives : The purpose of this report is to show the clinical efficiency of korean medical treatments with Bee Venom pharmacopuncture therapy on patient of Trigeminal Neuralgia. Methods : The patient was treated with Bee Venom pharmacopuncture, acupuncture, electroacupuncture, cupping venesection treatment, and herbal medicine. Visual Analog Scale was used to evaluate the improvement of pain after all treatments. Results : Visual Analog Scale was improved from 10 to 2 after korean medical treatment including Bee Venom pharmacopuncture. Conclusions : Korean medical treatments with Bee Venom pharmacopuncture can be effective for improving symptoms of Trigeminal Neuralgia.

The Antinociceptive Effect of Sigma-1 Receptor Antagonist, BD1047, in a Capsaicin Induced Headache Model in Rats

  • Kwon, Young-Bae;Jeong, Young-Chan;Kwon, Jung-Kee;Son, Ji-Seon;Kim, Kee-Won
    • The Korean Journal of Physiology and Pharmacology
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    • 제13권6호
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    • pp.425-429
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    • 2009
  • Intracranial headaches, including migraines, are mediated by nociceptive activation of the trigeminal nucleus caudalis (TNC), but the precise mechanisms are poorly understood. We previously demonstrated that selective blockage of spinal sigma-1 receptors (Sig-1R) produces a prominent antinociceptive effect in several types of pain models. This study evaluates whether the Sig-1R antagonist (BD1047) has an antinociceptive effect on capsaicin (a potent C-fiber activator) induced headache models in rats. Intracisternal infusion of capsaicin evoked pain behavior (face grooming), which was significantly attenuated by BD1047 pretreatment. BD1047 consistently reduced capsaicin-induced Fos-like immunoreactivity (Fos-LI), a neuronal activator, in the TNC in a dose-dependent manner. Moreover, capsaicininduced phosphorylation of N-methyl-D-aspartate receptor subunit 1 was reversed by BD1047 pretreatment in the TNC. These results indicate that the Sig-1R antagonist has an inhibitory effect on nociceptive activation of the TNC in the capsaicin-induced headache animal model.

Use of stellate ganglion block for treatment of recurrent syncope followed by chest pain

  • Kim, Young-ung;Shin, Yong-joon;Cho, Young Woo
    • Journal of Yeungnam Medical Science
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    • 제35권1호
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    • pp.104-108
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    • 2018
  • Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.

삼차신경절의 나트륨 채널 조절을 통한 치수염 통증 완화 효과 (Pulpitis pain relief by modulating sodium channels in trigeminal ganglia)

  • Kyung-Hee Lee
    • 한국치위생학회지
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    • 제24권3호
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    • pp.219-227
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    • 2024
  • 연구목적: 치수는 신경과 혈관을 포함하고 있는 부위로 다양한 자극이나 세균에 의해 염증이 생기면 이를 치수염이라고 한다. 치수염은 말초 신경조직 변화와 심한 통증을 유발하는 질환으로 만성적 통증을 유발하나, 삼차신경절의 신경세포 활성화와 특정 나트륨 채널(Nav1.7) 발현 사이의 관계는 잘 알려져 있지 않다. 이에 본 연구에서는 실험적으로 유도된 치수염이 말초신경에서 Nav1.7 나트륨 채널의 발현을 활성화시켜, 삼차신경절의 뉴런을 활성화함으로써 통증을 유발한다는 사실을 발견하고 이를 조절하는 신호기전을 규명하고자 하였다. 연구방법: 실험동물(Male C57BL/6 생쥐, 6주, 20-25 g)의 상악 제1대구치 치수에 AITC를 처리하여 급성 치수염을 유발하고, 3일 후 실시간 광영상 이미지를 이용하여 삼차신경절의 뉴런 활성화를 측정 및 비교 분석하였다. 단백질 분석을 통해 뇌간(SpVc)에서 치수염 통증유발 신호조절기전에 관여하는 여러가지 단백질들(p-ERK, c-FOS, TRPA1, p-CRMP2)의 발현을 관찰하였다. 연구결과: 시공간적 광영상 이미지를 통해 삼차신경절의 뉴런세포들은 대조군과 비교 시 급성 치수염 모델에서 흥분성 활성화가 유도되어 신경학적 변화가 일어남을 관찰하였다. 또한 조직학 및 분자생물학적 결과를 통해 치수염으로 인한 특정 나트륨 채널(Nav1.7)의 증가가 통증을 유발한다는 사실을 확인하였다. 또한, ProTxII(Nav1.7의 선택적 억제 약물) 처리를 통해 뉴런의 과흥분성 활성이 억제됨에 따라, 치수염이 삼차신경절에서 나트륨 채널(Nav1.7)의 증가를 유도하고 이러한 특정 나트륨 채널을 효과적으로 제어하면 치수염의 통증을 줄이는 방법이 될 것이라 생각된다. 결론: 본 연구의 결과를 통해 과 발현된 특정 나트륨 채널(Nav1.7)을 억제하면 삼차신경절에서 통각 신호 처리를 조절하고 치수염에 의해 유발되는 통증을 효과적으로 조절할 수 있음을 시사한다.

Percutaneous Balloon Compression of Trigeminal Ganglion for the Treatment of Idiopathic Trigeminal Neuralgia : Experience in 50 Patients

  • Park, Seong-Soon;Lee, Myung-Ki;Kim, Jae-Woo;Jung, Jin-Young;Kim, Ik-Soo;Ghang, Chang-Ghu
    • Journal of Korean Neurosurgical Society
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    • 제43권4호
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    • pp.186-189
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    • 2008
  • Objective : We assessed the surgical results of percutaneous balloon compression in 50 patients with idiopathic trigeminal neuralgia. Methods : Fifty patients with follow-up period of more than 12 months were retrospectively analyzed. The mean follow-up period was 42 months (range, 12-82). The mean age was 65.8 years (range, 27-83). Seventeen patients (34%) had other previous surgical procedures. The balloon was inflated by injecting radio-contrast media under brief general anesthesia according to Mullan’s technique. The mean inflating time was 88 seconds (range, 60-120). The whole procedure took about 20 minutes. Results : We reported excellent and good results in 70% of the cases, poor in 6% as annoying dysesthesia, recurrence in 16%, and 8% failure due to technical deficiencies. Forty-six patients (92%) were initially relieved of their pain. There were permanent motor weakness of the masseter muscle in 4% of patients and transitory diplopia in 8%. Neither anesthesia dolorosa nor keratitis occurred. Almost all patients (92%) were discharged postoperatively within two days. Conclusion : These results indicate that balloon compression would be an effective method with acceptable morbidity, technically, It can be performed rapidly and simply in the treatment of idiopathic trigeminal neuralgia.

Stevens-Johnson Syndrome Induced by Carbamazepine Treatment in a Patient Who Previously Had Carbamazepine Induced Pruritus - A Case Report -

  • Bae, Hyun Min;Park, Yoo Jung;Kim, Young Hoon;Moon, Dong Eon
    • The Korean Journal of Pain
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    • 제26권1호
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    • pp.80-83
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    • 2013
  • Stevens-Johnson syndrome (SJS) is a rare but life-threatening skin reaction disease and carbamazepine is one of its most common causes. We report a case of SJS secondary to carbamazepine in a patient with previous pruritus due to carbamazepine which was given for treatment of trigeminal neuralgia. We would like to caution all providers that carbamazepine readministration should be avoided in the patient with a previous history of SJS or adverse skin reaction. In addition, we strongly recommend gradual titration when initiating treatment with carbamazepine.

안면통에 동반된 가돌림신경의 지연 마비 증례: Tolosa-Hunt 증후군 -증례 보고- (Hemifacial Pain Accompanied with Delayed Ipsilateral Abducens Nerve Palsy: Tolosa-Hunt Syndrome -A case report-)

  • 심재광;문진천;윤경봉;김원옥;윤덕미
    • The Korean Journal of Pain
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    • 제19권1호
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    • pp.104-106
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    • 2006
  • Tolosa-Hunt syndrome is a rare self-limiting disease that's characterized by painful ophthalmoplegia. It has a relapsing and remitting course, and the pain responds promptly to systemic corticosteroid therapy. Yet it is diagnosed by the exclusion of other major causes involving the superior orbital fissure or cavernous sinus, including trauma, neoplasm, aneurysm and inflammation. Further, the associated ophthalmoplegia may follow days to weeks after the onset of orbital or hemifacial pain. Hence, this condition is often misdiagnosed as atypical facial pain, and so improper management could result in unnecessary suffering of the patient. The following case describes a patient suffering with hemifacial pain associated with ipsilateral abducens nerve palsy, which was evident 2 weeks after the onset of pain, and this was misdiagnosed as trigeminal neuralgia and atypical facial pain.

Effects of Somatostatin on the Substantia Gelatinosa Neurons of the Trigeminal Subnucleus Caudalis in the Adult Mice

  • Park, Seon-Ah;Yin, Hua;Bhattarai, Janardhan P.;Park, Soo-Joung;Han, Seong-Kyu
    • International Journal of Oral Biology
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    • 제34권4호
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    • pp.191-197
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    • 2009
  • Somatostatin (SST) is a known neuromodulator of the central nervous system. The substantia gelatinosa (SG) of the trigeminal subnucleus caudalis (Vc) receives many thinmyelinated $A{\delta}$-fiber and unmyelinated C primary afferent fibers and is involved in nociceptive processing. Many studies have demonstrated that SST plays a pivotal role in pain modulation in the spinal cord. However, little is yet known about the direct effects of SST on the SG neurons of the Vc in adult mice. In our present study, we investigated the direct membrane effects of SST and a type 2 SST receptor agonist, seglitide (SEG), on the SG neurons of the Vc using a gramicidin-perforated current clamp in adult mice. The majority (53%, n = 27/51) of the adult SG neurons were hyperpolarized by SST (300 nM) but no differences were found in the hyperpolarization response rate between males and females. When SST was applied successively, the second response was smaller ($76{\pm}9.5%$, n=19), suggesting that SST receptors are desensitized by repeated application. SST-induced hyperpolarization was also maintained under conditions where presynaptic events were blocked ($75{\pm}1.0%$, n=5), suggesting that this neuromodulator exerts direct effects upon postsynaptic SG neurons. SEG was further found to induce membrane hyperpolarization of the SG neurons of the Vc. These results collectively demonstrate that SST inhibits the SG neuronal activities of the Vc in adult mice with no gender bias, and that these effects are mediated via a type 2 SST receptor, suggesting that this is a potential target for orofacial pain modulation.

삼차신경통 환자에서 저출력레이저 조사에 따른 전류인지역치의 변화효과 (The Effects of Low Level Laser Therapy on Current Perception in Trigeminal Neuralgia Patients)

  • 허준영;태일호;고명연;안용우
    • Journal of Oral Medicine and Pain
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    • 제33권1호
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    • pp.97-103
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    • 2008
  • 본 연구는 부산대학병원 구강내과로 내원하여 삼차신경통으로 진단되어 사전에 실험에 대한 동의를 한 환자 20명(여자 13명, 남자 7명, $42{\sim}77$세, 평균$58.20{\pm}16.99$세)을 연구대상으로 저출력레이저 조사전,후 전류인지역치검사를 하여 다음과 같은 결과를 얻었다. 1. 레이저 조사전,후 이환측과 비이환측의 CPT값의 차이는 없었다. 2. 레이저 조사후 이환측과 비이환측의 CPT값 변화에 유의성은 없었다. 3. 하지만 레이저 조사후 이환측과 비이환측의 $A{\beta}$섬유의 경우 CPT값이 증가하는 경향을 보였다.