SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The autopsy findings in a patient with trigeminal neuralgia who died from unrelated causes are presented. Arterial cross compression of the appropriate trigeminal nerve at the pons was demonstrated. The relationship of arterial cross compression to trigeminal neuralgia is briefly discussed.
Uptake of horseradish peroxidase (HRP) in sensory nerve terminals in sinus hair in the nose of the mice was studied after local (s.c.) or i.v. injections. HRP spread into the sinus hair follicles and surrounded the nerve terminals of the Merkel disc endings and lanceolate terminals. It was incorporated into vacuoles and vesicles of these terminals. Subsequently, HRP was demonstrated in nerve cell bodies in the ophthalmo-maxillary part of the trigeminal ganglion, indicating a somatopetal axonal transport of the tracer. In this way the sensory neurons may be subjected to various influences from the periphery.
In eleven patients with atypical trigeminal neuralgia, following herpes infections or radiation therapy of cancer of the epipharynx, percutaneous electrical stimulation of the trigeminal tract or in the vicinity of the nucleus area was performed. Relief of pain lasting from fourteen days up to six weeks could be obtained.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Latent herpes simplex virus (HSV) has been demonstrated in the trigeminal ganglia of experimentally infected rabbits between episodes of spontaneous ocular recurrence. In three experiments reported here, the normal pattern of recurrence was modified by manipulation of the trigeminal nerve and ganglion. Temporary retrobulbar disruption of trigeminal nerve function in chronically infected animals significantly decreased the number of ocular HSV isolations obtained during the 20 weeks immediately following surgery. Stereotaxic interruption of intracranial trigeminal nerve function prior to initial HSV infection dramatically reduced the incidence of peripheral recurrence of HSV. In chronically infected animals, stereotaxic stimulation of the trigeminal ganglion caused a marked increase in positive cultures within 2 days. These studies provide additional evidence for the theory that the reservoir for latent ocular HSV in rabbits is the trigeminal ganglion. Moreover, the studies suggest that the transmission of latent HSV from the trigeminal ganglion to its infectious form in the peripheral tissues involves the trigeminal nerve. We have shown that mechanical and stereotaxic stimulation of the trigeminal ganglion is a reliable and rapid means of precipitating peripheral ocular shedding of HSV on command, a finding which should prove most productive in future research.
The rat trigeminal nerve was investigated as a model system for axonal transport to identifiable sensory nerve endings. Following stereotaxic injection of [3-H]proline into the ganglion, the distribution of label in protein and other extracts of ligated or unligated infraorbital nerve was measured in replicates at various time intervals from 30 min to 3 days. In unligated nerves the average maximum velocity of somatofugal protein transport was 228 mm/day. Light microscope autoradiography demonstrated rapid intraaxonal transport of radioactive material to nerve endings in molar teeth and vibrissae. The system appears suitable for investigating the fate of axonally transported material at peripheral receptors.
The investigation of film preparations and histological sections of human trigeminal nerves impregnated with silver nitrate and treated after Gomori, Falck--Hillarp demonstrated a rich innervation in the intraneural blood vessels. The most various and complex interconnections of the neural structures were noted in arterioles and venules of the node capsule, epineurium and external layers of perineurium of the trigeminal nerve branches. On the vessel walls of these layers, neural plexus were revealed. Sensitive innervation of the neural blood vessels mainly performed by posvalent tissue-vascular receptors. In the walls of intraneural vessels, adrenergic and cholinergic neural plexus are revealed.
The surgical management of trigeminal neuralgia has always been less than ideal. Evidence accumulated over the last 10 years suggests that the condition is caused by vascular compression of the trigeminal nerve root at the brain stem. Removal of this compression by means of micro-neurosurgical techniques has so far been very effective in relieving the pain of trigeminal neuralgia while maintaining normal facial sensation. A series of 10 patients who underwent this procedure is presented. All patients lost their pain, and during the follow-up period of six to 18 months, there have been no recurrences. This experience further demonstrates that the microvascular decompression is a very useful procedure in selected patients.
Antidromic stimulation of the trigeminal nerve produces an irritative response in the rabbit eye characterized by ipsilateral miosis, hyperemia, elevated intraocular pressure, and a disruption of the blood-aqueous barrier. The latter is a bilateral effect. The mediator or mediators involved in this response of the eye are unknown. Increased ATP levels in aqueous humor could be found after trigeminal stimulation. Treatment of rabbits with dipyridamole further increased ATP levels in aqueous humor after stimulation, confirming the findings of Holton that stimulation of sensory nerves causes a release of ATP. Intravitreal injections of ATP could not reproduce the ocular irritative response; however, an iridial hyperemia of long latency and an increase in aqueous humor protein levels were produced. The mechanism of this part of the reaction requires further study.
Somatosensory evoked potentials following trigeminal nerve stimulation can regularly be recorded from the contralateral scalp on C5/C6 (10--20 system), a region which overlies the primary face region of the somatosensory cortex. From the first three peaks analyzed (N 13, P 19 and N 26), the first positive peak (P 19) is most prominent and reliable and therefore is recommended for the routine measurements of neurophysiological examination.
Eighteen patients with intracranial trigeminal nerve lesions were investigated electrodiagnostically. The trigeminal motor root function was studied on the basis of the jaw reflex and masseter myograms and was disturbed in all cases. The jaw reflexes were abnormal in 16 and the masseter myograms in eight cases. An impressive trigeminal sensory root function was obtained from blink reflex, which was abnormal in 12 cases. The results show the diagnostic value of bilateral recording of the jaw reflex in such patients.
200 cases of percutaneous thermocoagulation of the trigeminal nerve were studied in order to determine if the position of the thermolesion in the various parts of the trigeminal system modified the quality of the results and the frequency of post-operative complications. An anatomo-radiological study allowed the precise localisation in the sagittal plane of the position of the different parts of the trigeminal ganglion with respect to the neighbouring bony features. The quality of the results and the frequency of complications were studied according to the level of the thermolesion (ganglion, triangular plexus, posterior sensory root). This study permitted the observation that the more posterior the thermolesion, the less frequent the complication, and this confirmed results obtained in earlier procedures, c.g. gasserian or retro-gasserian neurotomy. Post-operative hypoaesthesia extending beyond the painful area, was the major side-effect of the radicular position of the thermolesion. There follows a discussion of the criteria, which permit the recognition of the point of the electrode at the level of the posterior root: the flow of CSF, vasodilatation, and radiological localisations. Of these three criteria, only radiological demonstration (point of the needle posterior to the clivus and above the petrous temporal bone) seemed reliable.
A case of trigeminal neuralgia which was apparently caused by compression of the trigeminal nerve by a pontine vein is presented. Complete relief followed the coagulation and dissection of the vein.
Projections from the spinal (Vsp) and the principle sensory (Vp) nuclei of the trigeminal nerve to the cerebellar cortex were studied by means of retrograde transport of horseradish peroxidase in the cat. Neurons projecting to the simple lobule and the dorsal part of the paramedian lobule (PMD) were located mainly in the dorsal part of the nucleus interpolaris (Vi) and of the caudal one third of the nucleus oralis (Vo) and in the rostralmost part of the Vo. Neurons projecting to the medial part of the posterior folia of crus II (crus IIp) were located in the dorsal to ventral parts of the Vi and of the caudal one third of the Vo and in the rostralmost part of the Vo, while those projecting to the lateral part of crus IIp were confined to the ventral part of the Vi and of the caudal one third of the Vo. Neurons of the Vp also projected to all of these cortical areas. They were relatively confined to the ventral part of this nucleus. Thest trigeminocerebellar projections were exclusively ipsilateral to the cell origin. There were sparse projections from the Vi and Vo to lobules V to VIIIa. In addition, a small group of neurons in the subnucleus magnocellularis of the nucleus caudalis of the Vsp also projected to the above cortical areas. No projections were, however, observed to the anterior portion of the anterior lobe, crus I, the anterior folia of crus II, paraflocculus, flocculus and the ventral part of the PMD. The majority of these cerebellar projection neurons were medium-sized and triangular, fusiform or ovoid in shape. There were small neurons of similar types and large multipolar neurons as well.
Explore the source record for details and available documents.
Fine points of the technique of selective percutaneous radiofrequency trigeminal neurolysis relative to patient preparation accurate and rapid foramen ovale puncture, electrode positioning, and neurolytic lesions are discussed. These measures. which have evolved from our experience in treating trigeminal neuralgia by this method over the last 4 years, have made the procedure safer and less painful but also significantly more expedient.
Twelve chemical rhyzolisis (surgical instilation of 10 c.c. of 15% NaCl solution) of trigeminal nerve were performed in 11 patients with trigeminal neuralgia resistent to medical treatment. Before and at least in the first 30 minutes after instilation the following parameters were monitorized: electrocardiogram, electroencephalogram, intrarradial arterial pressure and venous central pressure. In 10 cases after a 2.8 +/- 2.4 seg. latency period the following arrhythmias appeared (in paragraphs number of cases): sinus bradicardia, sinoauricular block, sinus arrest, atrial-ventricular block and atrial pacemaker migration. During sinus arrest (8 episodes in 4 cases; mean duration 17.6 secs.) slow, high voltage waves appeared in the electroencephalographic tracings. Ventricular scapes were not seen at the end of the sinus pauses. In 6 cases after this slow arrhythmic phase the following arrhythmias were observed: ventricular premature beats, atrial premature beats, sinus tachycardia, bidirectional ventricular tachycardia, and nodal tachycardia. All cases exhibited an elevation of mean arterial pressure after instilation of the nerve which was preceded by a short period of hypertension in 4 occasions. Average and standard deviations changes of systolic, diastolic and mean blood pressure (mm of Hg), pulse (beats/minute) and central venous pressure (cms of H2O) during the procedure were 46.7 +/- 29.3, 23.0 +/- 13.3, 34.1 +/- 16.4, 25.8 +/- 16.2 and 6.6 +/- 5.8, respectively (p less than or equal to 0.001) in all changes but the last ones, less than or equal to 0.05). Physiopathologic considerations of this autonomic crises are done.