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At least 19 recordsLinked to original sources
PubMed1976

[Odontologic and other etiologic factors in trigeminal neuralgia].

Trigeminal neuralgia may be due to many causes, being in this respect secondary. To a certain degree trigeminal neuralgia may be facilitated by an individual increase of reactivity in the trigeminal system to noxious factors. For this reason, in treating trigeminal neuralgia, it is necessary first of all to take into consideration the possible etiological factors including different diseases of the teeth, in the innervation of which an important role is played by the fibers of the trigeminal nerve.

Adult↗
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↗
PubMed1979

Trigeminal neuralgia. Surgical treatment by microvascular decompression of the trigeminal nerve root.

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.

Aged↗
PubMed1978

Trigeminal neuralgia in aqueduct stenosis.

Trigeminal neuralgia was the presenting symptom in two patients with aqueduct stenosis, hydrocephalus, and raised intracranial pressure. Treatment of the hydrocephalus resulted in the remission of pain in both patients.

Adult↗
PubMed1977

Radiofrequency thermocoagulation of Gasserian ganglion and its rootlets for trigeminal neuralgia.

Thirty-nine patients with trigeminal neuralgia, not controlled by medical treatment, were treated by radio-frequency thermocoagulation of the Gasserian ganglion and its posterior rootlets. Thirty-six received satisfactory pain relief. In 30 patients touch sensation in the treated territory was preserved. The corneal reflex was affected in only six patients, two of whom subsequently developed keratitis. There were no other complications apart from a minor unpleasant sensation in eight patients. By selectively destroying pain fibres this technique offers the scope of preserving touch sensation in the treated area. Moreover, the zone of analgesia can be restricted to the affected region by sensory mapping through electrode stimulation before thermocoagulation. Its simplicity, low morbidity, associated short hospital stay, and the increased ability to preserve touch sensation, especially of the cornea, seem to make it preferable to other forms of surgical management for trigeminal neuralgia.

Adult↗
PubMed1979

[Trigeminal neuralgia. Percutaneous thermocoagulation of the trigeminal nerve (author's transl)].

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.

Adult↗
PubMed1978

Role of the dentist in trigeminal neuralgia.

It is well known that people with idiopathic trigeminal neuralgia sometimes have teeth unnecessarily extracted. It is less well known that pain which seems to be due to idiopathic trigeminal neuralgia is occasionally due to dental causes. For this reason it is suggested that such cases should be given very careful dental and oral examination before the commencement of drug therapy or surgery. Such an examination must be meticulous and may be tedious as well as time consuming. It should therefore be done by a dentist who is specially interested in pain and who is preferably associated with a centre for pain relief. A few cases may then have their pain relieved by such procedures as fillings, extractions or occlusal adjustment. In all cases the neurologist or neurosurgeon will face his responsibility more secure in the knowledge that all possible peripheral causes have been eliminated. Moreover, patients with idiopathic trigeminal neuralgia may have difficulty maintaining a satisfactory standard of oral hygiene, both before and after treatment. They should therefore have careful attention paid to this as soon as possible.

Adult↗
PubMed1978

Percutaneous radio-frequency rhizotomy in the treatment of trigeminal neuralgia.

A percutaneous technique of selective partial trigeminal root coagulation was evaluated in the treatment of 38 patients suffering from trigeminal neuralgia, 1 patient with pain secondary to oral carcinoma and 1 patient with atypical facial pain. The pain of trigeminal neuralgia was relieved in 94.7 percent of patients. Pain was relieved in the patient with oral carcinoma, but not in the patient with atypical facial pain. There was no mortality and no permanent morbidity outside of the trigeminal nerve lesion. The procedure requires only a brief hospital stay without the time, expense and hazards of open cranial surgical procedures.

Adult↗
PubMed1975

Treatment of trigeminal neuralgia in the aged by a simplified surgical approach (percutaneous electrocoagulation).

Trigeminal neuralgia can be excruciatingly painful. For aged patients, among whom trigeminal neuralgia most commonly occurs, medical therapy may often afford relief of pain. However, since this disorder is likely to become worse with increasing age, medical therapy eventually may fail because of increasing drug requirements and intolerable side effects. Major forms of surgical treatment requiring craniotomy may afford longstanding relief but are associated with significant side effects in 3-5 per cent of cases. For these reasons the authors began to test a new surgical approach, i.e., stereotaxic percutaneous electrocoagulation of the trigeminal nerve. More than 300 patients have been treated by this technique in the past five years. Successive radiofrequency lesions allow the production of a graded sensory deficit sufficient to relieve pain while preserving touch and motor function in the face. Unnecessary suffering from the severe pain of trigeminal neuralgia need not occur because of age or a debilitated condition which might ordinarily preclude surgical treatment. More than 100 patients over 65 years of age (4 of them older than 90) have been treated. Of this group, 93 per cent reported good to excellent results. Seven per cent have had some recurrent pain during the follow-up period; however, recoagulation has been required in only 5 per cent of these patients. Recoagulation may be readily performed in any patient who shows evidence of fading of the sensory deficit. The electrocoagulation technique and the results in elderly patients are discussed.

Aged↗
PubMed1977

The place of ganglion or root alcohol injection in trigeminal neuralgia.

Of 157 patients with trigeminal neuralgia, referred for neurosurgery, 81 underwent 85 ganglion or root injections. The results, which are analysed with regard to pain relief and sensory loss, compare favourably with results from the literature of other forms of surgery, particularly open temporal root section.

Adult↗
PubMed1977

Symptomatic trigeminal neuralgia in a 5-year-old child.

Trigeminal neuralgia is a rare symptom in childhood. In the idiopathic variety, no objective neurological deficit is demonstrable, but in the symptomatic or secondary form, deficits of trigeminal function may be found. In the latter circumstance, underlying causative pathology must be looked for vigorously, as emphasized by the present case of symptomatic trigeminal neuralgia in a 5-year-old child, determined to be secondary to an infiltrating embryonal rhabdomyosarcoma.

Biopsy↗
PubMed1979

High cervical neurinoma (C1/C2) diagnosed falsely as multiple sclerosis because of trigeminal neuralgia.

Remitting paresis of the left leg accompanied by left trigeminal neuralgia led to the diagnosis of multiple sclerosis in a 46-year-old woman. Over the following 6 years, an incomplete syndrome of the spinal cord developed along with bilateral trigeminal pain. Neuroradiological and neurosurgical exploration a neurinoma located ventrolaterally at C1/C2 on the left side. It is emphasized that since trigeminal fibres descend as far as the upper part of the C2 segment, trigeminal neuralgia should not be considered as an exclusively supraspinal symptom.

Cerebral Palsy↗
PubMed1975

The use of bupivacaine for blocking the Gasserian ganglion in major trigeminal neuralgia.

Five patients are reported with major trigeminal neuralgia in whom medicamentous therapy and/or peripheral blocking of the trigeminal nerve branches was unsuccessful in relieving pain attacks for appreciable periods. Under fluoroscopic control, 0.6 to 1.5 ml of a 0.5% bupivacaine solution (without added vasoconstrictor) was injected into the ganglion. In two patients with the cannula secured at its proper place, after 3 to 5 hours a second injection was given. Immediate complete anesthesia was induced in all patients in the whole innervation area of the trigeminal nerve. Conjunctival as well as corneal reflexed could not be stimulated. Sensibility returned after 24 to 72 hours, algesia being the function last restored; at this time, the eye reflexes were positive again. In spite of recovered sensibility, the patients remained free from typical paroxysmal attacks for several months or even years. Residual pain was easily combated by carbamazepine. Bupivacaine injections were well tolerated; no ill-effects of the drug were observed. In two patients disturbances were seen that are not uncommon after intrathecal injections.

Aged↗
PubMed1979

Trigeminal neuralgia and multiple sclerosis: demonstration of the plaque in an operative case.

Trigeminal neuralgia is unique to humans. The most common cause seems to be an injury to the myelin of the trigeminal nerve root entry zone as it extends for several millimeters lateral to the pons. Jannetta has developed an elegant retromastoid microsurgical approach to this region. He has identified a compression-distortion phenomenon of this nerve root entry zone, usually from an anomalous position of the superior cerebella artery. Trigeminal neuralgia can also occur in association with multiple sclerosis, when the plaque lies in this same location. The historical evidence for this explanation is reinforced by the electron microscopic demonstration of the plaque in this region in a patient with multiple sclerosis who was suffering from tic douloureux. (Neurosurgery, 5: 711--717, 1979).

Female↗
PubMed1976

[Complications of the operative neurosurgical treatment of trigeminal neuralgia].

The complications after neurosurgical treatment of trigeminal neuralgia of 161 patients treated in the neurosurgical hospital university medical school Bonn from 1971 to 1974 are referred. Emphasis is layed on severe complications. After rhizotomia (Dandys method) 3 patients died, one of them because of a meningitis, one of them because of damage of the superior petrosal vein and one after ligature of an irregular auditive artery. One patient died after electrocoagulation of the ganglion Gasseri (Kirschner's method) after having had an important bleeding during coagulation. Another patient developed hemiparesis after a strong arterial bleeding during electrocoagulation. The damage of importance arterial vessels seems to be decisive. Three proposals in order to diminish the risk of the operations are settled: 1. Preoperative neuroradiological checks by means of contrast. 2. Carefully sparing of vessels, especially when precedent scars had alterated the field of operation, perhaps if necessary by means of the operation mikroscope. 3. Control of the lokalisation of the needle during electrocoagulation by X-rays.

Aged↗