• Title/Summary/Keyword: trigeminal pain

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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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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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Blockade of Trigeminal Glutamate Recycling Produces Anti-allodynic Effects in Rats with Inflammatory and Neuropathic Pain

  • Yang, Kui-Ye;Lee, Min-Kyung;Park, Min-Kyoung;Son, Jo-Young;Ju, Jin-Sook;Ahn, Dong-Kuk
    • International Journal of Oral Biology
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    • v.42 no.3
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    • pp.129-135
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    • 2017
  • The present study investigated the role of spinal glutamate recycling in the development of orofacial inflammatory pain or trigeminal neuropathic pain. Experiments were carried out on male Sprague-Dawley rats weighing between 230 and 280 g. Under anesthesia, a polyethylene tube was implanted in the atlanto-occipital membrane for intracisternal administration. IL-$1{\beta}$-induced inflammation was employed as an orofacial acute inflammatory pain model. IL-$1{\beta}$ (10 ng) was injected subcutaneously into one vibrissal pad. We used the trigeminal neuropathic pain animal model produced by chronic constriction injury of the infraorbital nerve. DL-threo-${\beta}$-benzyloxyaspartate (TBOA) or methionine sulfoximine (MSO) was administered intracisternally to block the spinal glutamate transporter and the glutamine synthetase activity in astroglia. Intracisternal administration of TBOA produced mechanical allodynia in naïve rats, but it significantly attenuated mechanical allodynia in rats with interleukin (IL)-$1{\beta}$-induced inflammatory pain or trigeminal neuropathic pain. In contrast, intracisternal injection of MSO produced anti-allodynic effects in rats treated with IL-$1{\beta}$ or with infraorbital nerve injury. Intracisternal administration of MSO did not produce mechanical allodynia in naive rats. These results suggest that blockade of glutamate recycling induced pro-nociception in na?ve rats, but it paradoxically resulted in anti-nociception in rats experiencing inflammatory or neuropathic pain. Moreover, blockade of glutamate reuptake could represent a new therapeutic target for the treatment of chronic pain conditions.

Linear Accelerator Radiosurgery for Trigeminal Neuralgia: Case Report (선형가속기를 이용한 삼차신경통의 정위적 방사선수술: 증례보고)

  • Yun Hyong-Geun
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.144-148
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    • 2006
  • Trigeminal neuralgia is defined as an episodic electrical shock-like sensation in a dermatomal distribution of the trigeminal nerve. When medications fail to control pain, various procedures are used to attempt to control refractory pain. Of available procedures, stereotactic radiosurgery is the least invasive procedure and has been demonstrated to produce significant pain relief with minimal side effects. Recently, linear accelerators were introduced as a tool for radiosurgery of trigeminal neuralgia beneath the already accepted gamma unit. Author have experienced one case with trigeminal neuralgia treated with linear accelerator. The patient was treated with 85 Gy by means of 5 mm collimator directed to trigeminal nerve root entry zone. The patient obtained pain free without medication at 20 days after the procedure and remain pain free at 6 months after the procedure. He didn't experience facial numbness or other side effects.

Participation of D-serine and NR2 subunits in EphA4-mediated trigeminal neuropathic pain

  • Kim, Myung-Dong;Kim, Min-Ji;Son, Jo-Young;Kim, Yu-Mi;Ju, Jin-Sook;Ahn, Dong-Kuk
    • International Journal of Oral Biology
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    • v.45 no.3
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    • pp.84-91
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    • 2020
  • The present study investigated the participation of D-serine and NR2 in antinociception produced by blockade of central erythropoietin-producing hepatocellular carcinoma (Eph) A4 (EphA4) signaling in rats with trigeminal neuropathic pain. Trigeminal neuropathic pain was modeled in male Sprague-Dawley rats using mal-positioned dental implants. The left mandibular second molar was extracted under anesthesia, and a miniature dental implant was placed to induce injury to the inferior alveolar nerve. Our current findings showed that nerve injury induced by malpositioned dental implants significantly produced mechanical allodynia; additionally, the inferior alveolar nerve injury increased the expression of D-serine and NR2 subunits in the ipsilateral medullary dorsal horn (trigeminal subnucleus caudalis). Intracisternal administration of EphA4-Fc, an EphA4 inhibitor, inhibited nerve injury-induced mechanical allodynia and upregulated the expression of D-serine and NR2 subunits. Moreover, intracisternal administration of D-amino acids oxidase, a D-serine inhibitor, inhibited trigeminal mechanical allodynia. These results show that D-serine and NR2 subunit pathways participate in central EphA4 signaling after an inferior alveolar nerve injury. Therefore, blockade of D-serine and NR2 subunit pathways in central EphA4 signaling provides a new therapeutic target for the treatment of trigeminal neuropathic pain.

Atypical triggers in trigeminal neuralgia: the role of A-delta sensory afferents in food and weather triggers

  • Koh, Wenjun;Lim, Huili;Chen, Xuanxuan
    • The Korean Journal of Pain
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    • v.34 no.1
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    • pp.66-71
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    • 2021
  • Background: Trigeminal neuralgia is a debilitating craniofacial pain syndrome that is characterized by paroxysms of intense, short-lived electric shock-like pains in the trigeminal nerve distribution. Recently, the presence of triggers has become one of the key diagnostic criteria in the 3rd edition of the International Classification of Headache Disorders. Light touch is the most common trigger, however other non-mechanical triggers, such as cold weather and certain foods, have been thought to provoke trigeminal neuralgia anecdotally. We aimed to characterize the prevalence and characteristics of these atypical triggers. Methods: We conducted a retrospective, cross-sectional study of atypical triggers in trigeminal neuralgia patients seen in a tertiary pain clinic in Singapore. Patients were recruited via clinic records, and study data were identified from physician documentation. Results: A total of 60 patients met the inclusion criteria. Weather triggers were observed in 12 patients (20%), of which five patients (8%) reported strong winds, 4 patients (7%) reported cold temperatures, and 3 patients (5%) reported cold winds as triggers. Fifteen patients (25%) had a specific food trigger, of which 10 patients (17%) reported hard or tough food, 5 patients (8%) reported hot/cold food, 4 patients (7%) reported spicy food, and 2 patients (3%) reported sweet food as triggers. Conclusions: Although trigeminal neuralgia is most commonly triggered by mechanical stimuli, atypical triggers such as cold temperatures and certain foods are seen in a significant proportion of patients. These atypical triggers may share a common pathway of sensory afferent Aδ fiber activation.

A Case Report of Trigeminal Neuralgia diagnosed weakness During Pregnancy (허증(虛症)으로 변증된 임신 중 삼차신경통 치험(治險) 1례(例))

  • Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub;Kim, Kyung-Jik
    • 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.

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Maxillary Nerve Block for Patient with Trigeminal Neuralgia (삼차신경통환자의 상악신경 차단 -증례보고-)

  • Lim, Jung-Ae;Lee, Sang-Hun;Woo, Nam-Sik;Lee, Ye-Chul;Kim, Chan
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.303-306
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    • 1994
  • Trigeminal neuralgia is a unique disease entity to be dealt with at pain clinic due to it's severe pain attack. A 33-year old male patient had severe pain on left cheek area usually initiating from first upper molar tooth area for three years. We successfully treated this patient with maxillary nerve block using pure alcohol by a lateral approach. Three months after maxillary block the patient is still pain free.

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Compression of The Trigeminal Ganglion Enhances Nociceptive Behavior Produced by Formalin in The Orofacial Area of Rats

  • Yang, Gwi-Y.;Park, Young-H.;Lee, Min-K.;Kim, Sung-K.;Ahn, Dong K.
    • International Journal of Oral Biology
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    • v.33 no.4
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    • pp.155-162
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    • 2008
  • The present study investigated inflammatory hypersensitivity following compression of the trigeminal ganglion in rats. Experiments were carried out on male Sprague-Dawley rats weighing 250-260 g. Under anesthesia, rats were mounted on a stereotaxic frame and injected with $8{\mu}L$ of 4% agar solution through a stainless steel injector to compress the trigeminal ganglion. In the control group, rats underwent a sham operation without agar injection. Injection sites were examined with a light micrograph after compression of the trigeminal ganglion. Air-puff thresholds (mechanical allodynia) were evaluated 3 days before surgery and 3, 7, 10, 14, 17, 21, 24, 30, and 40 days after surgery. Air-puff thresholds significantly decreased after compression of the trigeminal ganglion. Mechanical allodynia was established within 3 days and remained strong over 24 days, returning to preoperative levels approximately 40 days following compression. After subcutaneous injection of 5% formalin ($50{\mu}L$) in the compression of the trigeminal ganglion-treated rats, nociceptive scratching behavior was recorded for 9 successive 5-min internals. Injection of formalin into the vibrissa pad significantly increased the number of scratches and duration of noxious behavioral responses in sham-treated rats. Noxious behavioral responses induced by subcutaneous formalin administration were significantly potentiated in rats with trigeminal ganglion compression. These findings suggest that compression of the trigeminal ganglion enhanced formalin-induced infla-mmatory pain in the orofacial area.

Clinical Features of Trigeminal Neuralgia (삼차신경통 환자의 임상적 특성 분석)

  • Han, Kyung Ream;Kim, Yeui Seok;Kim, Chan
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.174-180
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    • 2007
  • Background: The diagnosis of trigeminal neuralgia (TN) is based on only clinical criteria. The purpose of this study was to estimate the clinical manifestations of TN patients treated at our pain clinic. Methods: A total of 341 patients with TN from Jan. 2004 to Dec. 2006 was evaluated the intensity, site, and onset of pain, facial sensation, duration of pain attack, pain free interval, triggering factors, and effects of the previous treatments with TN specific questionnaire and interview at the first visit of our pain clinic. Results: About 80% of the patients were over 50 years of age and 256 (75%) patients were women. Average durations from first attack of their pain and from current pain attack were 7 years and 16 weeks, respectively. The two most frequently involved trigeminal nerve branches were maxillary (40%) and mandibular (39%) branches. Three quarters of the total patients experienced only paroxysmal pain that lasted less than one minute. About 90% of patients had pain free period at least one time. Most common triggering factors were chewing (88%), brushing teeth (82%), washing face (79%), and talking (70%). Only 16 patients (5%) had no previous treatment and the others had more than one treatment, such as medication (68%) and interventional procedures (35%). The most common reasons for early discontinuation of carbamazepine were dizziness, ataxia, and vomiting. Conclusions: TN has specific clinical features of pain, which should be considered at diagnosis.