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PubMed1978

Application of stereotactic principles to the treatment of trigeminal neuralgia.

The application of neuroanatomical and neurophysiological principles to the functional surgery of the trigeminal nerve is discussed. Particular attention has been directed toward correlating the three-dimensional anatomical features of the trigeminal nerve and the surrounding structures to the two-dimensional radiograph of this same region. In this regard, 20 trigeminal nerves, including the surrounding neurovascular structures from 10 cadaver sphenoid blocks, were examined. Measurements of the third, fourth and sixth cranial nerves in relation to the profile of the clivus were made from lateral radiographs of the sphenoid blocks. The position of the internal carotid artery in relation to these structures was also noted. These neurovascular relationships are of clinical importance when using the percutaneous thermocoagulation technique for the treatment of trigeminal neuralgia.

Electrocoagulation↗
PubMed2025

Exploring the causal relationship between plasma proteins and postherpetic neuralgia: a Mendelian randomization study.

BACKGROUND: The proteome represents a valuable resource for identifying therapeutic targets and clarifying disease mechanisms in neurological disorders. This study investigated potential causal relationships between plasma proteins and postherpetic neuralgia (PHN). METHODS: We conducted a two-sample Mendelian randomization (MR) analysis using genome-wide association study (GWAS) summary statistics from the Decode Genetics dataset (4,907 plasma proteins) and the FinnGen database (490 PHN cases and 435,371 controls). Instrumental variables (IVs) were selected based on relevance, independence, and exclusivity. Causal associations were assessed using inverse-variance weighted (IVW), MR-Egger regression, simple mode, weighted mode, and weighted median methods. Sensitivity analyses, including leave-one-out tests, evaluated result robustness, while colocalization analysis examined shared causal variants between traits. RESULTS: Eight plasma proteins showed significant associations with PHN (PFDR < 0.05). Higher levels of ATRN, PIANP, and CD48 correlated with increased PHN risk, whereas elevated KIR2DL5A, GPI, SEMG2, EIF4B, and HFE2 levels were associated with reduced risk. Sensitivity analyses supported these findings and excluded genetic pleiotropy as a major confounding factor. Colocalization analysis did not detect shared causal variants (PPH4 < 0.8). CONCLUSION: These results suggest a potential causal role for eight plasma proteins in PHN pathogenesis. While these proteins may serve as biomarkers or therapeutic candidates, further validation is required. This study advances understanding of PHN pathophysiology and supports future investigations into diagnostic and therapeutic strategies.

Mendelian randomization↗
PubMed2026

A Standardized Nursing-Led Protocol Integrated Pain, Sleep, Medication Adherence, and Symptom Management in Postherpetic Neuralgia.

Postherpetic neuralgia (PHN) is a persistent neuropathic pain condition after herpes zoster that frequently coexists with sleep disturbance, medication-related problems, and fluctuating symptoms. This study evaluated whether a standardized nursing-led protocol could improve multidimensional short-term outcomes beyond usual care. In this prospective, parallel-group randomized controlled trial, 128 adults with PHN were allocated 1:1 to usual care or usual care plus an eight-week protocol integrating structured pain assessment, sleep monitoring, medication-adherence support, and rule-based digital symptom monitoring. The primary outcome was the between-group difference in change in Numeric Rating Scale (NRS) pain score from baseline to Week 8. Secondary outcomes included Pittsburgh Sleep Quality Index (PSQI), MMAS-8 medication adherence, symptom burden, pain-related nocturnal awakenings, breakthrough pain, rescue analgesic use, adverse events, rule-based alerts, and nursing satisfaction. Week-8 data were available for 116 participants (57 usual care; 59 protocol). Mean NRS scores decreased from 7.19 &#xb1; 1.08 to 4.82 &#xb1; 1.53 in the usual-care group and from 7.28 &#xb1; 1.05 to 3.24 &#xb1; 1.28 in the protocol group. An NRS reduction of at least 2 points occurred in 49.1% and 76.3% of participants, respectively. The protocol group also showed larger improvements in PSQI, MMAS-8, symptom burden, and nocturnal awakenings, with fewer breakthrough-pain episodes and less rescue-analgesic use. These findings support further evaluation of the standardized nursing-led protocol in preregistered multicenter trials with intention-to-treat analyses and longer follow-up.

Humans↗
PubMed1979

[Dental aspects of atypical neuralgia in the maxillofacial region (author's transl)].

The complicated anatomy of the masticatory system with its coordinated functional elements offers a multitude of noxae for atypical neuralgias. More specifically, affections of the pulp, apical periodontopathies with cyst formation, impacted teeth, aggressive osteopathies and malignant growth come into consideration. In addition, dysfunctional unions must be borne in mind. The styloid syndrome also deserves attention. Because of this causal complex the discovery of other puzzling painful conditions needs dental investigation.

Dental Pulp Diseases↗
PubMed1977

Transantral maxillary neurectomy for intractable neuralgia.

A case of atypical facial pain over the distribution of the maxillary nerve (V2) has been presented as well as its treatment. The maxillary nerve section using the dissecting microscope is a relatively new procedure with potential to become an accepted treatment of intractable V2 neuralgia. A brief review of possible complications of the procedure was presented.

Humans↗
PubMed1978

[Therapeutic considerations in maxillofacial neuralgia].

In the presence of idiopathic and neuralgiform pain in the trigeminal area, differential diagnosis will have to eliminate sinus disturbances, toothache, TMJ trouble and neuromuscular spasms derived thereof. Neuralgias unconnected to these causes are treated by electrobiological testing of the neurotoxins. Symptomatic immediate treatment was formerly done by enneural injection. Now, a special technique of auriculoacupuncture has been successful for some time.

Acupuncture Therapy↗
PubMed1978

[Dental and gnathological aspects of facial neuralgia (author's transl)].

Disturbances of dental occlusion may lead to hyperactivity of the regional musculature, accompanied by a displacement of the lower jaw. The muscle and joint pains which then occur are the principal causes of the complex picture of facial neuralgia from the gnathological point of view, but the emotional factor must not be overlooked. The dental treatment of the pain syndrome demands extremely high expenditure in time and technical equipment. It usually consists of repositioning the displaced mandible with subsequent stabilization by dental technical measures. It is, moreover, important to keep parafunctional activity of the masseter muscles as low as possible or to suppress it altogether by purposeful arrangement of the occlusal surface complex.

Dental Occlusion, Balanced↗
PubMed1978

[Neurosurgical treatment of trigeminal neuralgia].

Sweet's method for thermocoagulation of the Gasserian ganglion is a real advance in the operative treatment of trigeminal neuralgia. The advantages of this method are obvious: minimum operation risk, minimum complication rate, short postoperative convalescence, shorter confinement to hospital and finally the possibility of repeating the operation without risk in the event of a relapse.

Electrocoagulation↗
PubMedDate not supplied

[Recurrent attacks of facial neuralgia (author's transl)].

The author reports one case of sedation by tiapride of severe and recurrent attacks of facial neuralgia. Knowing the rather poor therapeutic means for this disease, it is suggested to extend the use of this recent neurotropic drug to this purpose.

Aged↗
PubMed1979

[Stereotaxia in phantom-limb-neuralgia and causalgia (author's transl)].

Intractable pain is an important indication for stereotactic operations in deep structures of the brain. The targets are situated in primary and secondary sensomotoric regions of the thalamus, dependent or independent on cortical areas. In clinical practice it is necessary to combine two or three targets in the thalamic nuclei. In more than 25% the destruction of parts of the emotional pain-perception is necessary (ncl. dorso-medialis). The results os stereotactic operations in 32 patients with causalgia and phantom-limb-neuralgia are analysed.

Causalgia↗
PubMed1979

[Trigeminal neuralgia. Classical clinical and therapeutic aspects. Advantages of a modern method: controlled differential heat coagulation].

The main clinical aspects of essential trigeminal neuralgia are reported and traditional medical and surgical therapy reviewed. Results obtained in 114 patients treated with a modern method, controlled differential thermocoagulation, are then analysed. This consists of percutaneous infiltration of Gasser's ganglion and/or retrogasserian roots and in causing thermolesions by means of radiofrequency, i.e. using constantly controlled and steadily increasing temperatures which selectively damage the finer painful facial fibres without affecting the more resistant tactile fibres. While the principal advantage of this method lies in the elimination of pain with partial saving of facial tactile sensitivity, other practical advantages are of no less importance: these include the fact that the method is so harmless that all patients, even those of advanced age, could leave hospital at the latest one day after treatment.

Basal Ganglia↗
PubMed1979

Trigeminal neuralgia: compression of the trigeminal nerve by an elongated and dilated basilar artery.

A patient with trigeminal neuralgia caused by direct compression by an elongated basilar artery of the 5th nerve at the zone of entry of its sensory root into the pons is presented. Rhizotomy of the portio major is a treatment of choice in such a case instead of simple microsurgical decompression. The elongated basilar artery is very firm and not readily movable with manipulation.

Basilar Artery↗