Stimulation of the Gasserian ganglion in the treatment of refractory trigeminal neuropathy

2017 ◽  
Vol 45 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Lise Kustermans ◽  
Jean-Pierre Van Buyten ◽  
Iris Smet ◽  
Wim Coucke ◽  
Constantinus Politis
Keyword(s):  
Gasserian Ganglion ◽  
Trigeminal Neuropathy ◽  
Stimulation Of

Suppression of Pain in Trigeminal Neuropathy by Electric Stimulation of the Gasserian Ganglion

Neurosurgery ◽  
1986 ◽  
Vol 18 (1) ◽  
pp. 59-66 ◽  
Author(s):  
B. A. Meyerson ◽  
S. Håkanson
Keyword(s):  
Pain Relief ◽  
Trigeminal Ganglion ◽  
Gasserian Ganglion ◽  
Direct Stimulation ◽  
Trigeminal Neuropathy ◽  
Electrode Implantation ◽  
Transcutaneous Nerve Stimulation ◽  
Selection Of ◽  
Stimulation Of

Abstract Lesions of the peripheral part of the trigeminal nerve may cause trigeminal neuropathy associated with severe pain. Such pain usually does not respond to carbamazepine and analgesics, and it is continuous and lacks the characteristic paroxysmal character of tic douloureux. These patients often present with complex changes of facial sensibility in the form of dysesthesia, hyperalgesia, and allodynia. The pain sometimes responds favorably to transcutaneous nerve stimulation, but direct stimulation of the trigeminal ganglion and rootlets via an implanted electrode provides a greater likelihood of pain relief. Fourteen patients diagnosed as having painful trigeminal neuropathy received implants of a gasserian ganglion-stimulating electrode. The mean follow-up period is 4 years (range, 1 to 7 years). Eleven of the patients have retained the pain-relieving effect, and 1 had pain disappear without further stimulation. Eight of the patients estimated their pain relief to be complete or very good. There were no serious complications, but in several of the patients the electrode had to be exchanged because the insulation of the lead wires broke. For the selection of patients for permanent electrode implantation, a method has been developed for trial stimulation via a percutaneous electrode introduced into the trigeminal cistern. Temporary trial stimulation can be performed for several days. It is concluded that stimulation of the trigeminal ganglion and rootlets with the aid of an implanted electrode may effectively relieve certain forms of trigeminal pain that are otherwise extremely difficult to manage.

scholarly journals Trigeminal neuropathy: Two case reports of gasserian ganglion stimulation

2021 ◽  
Author(s):  
Yannick Logghe ◽  
Iris Smet ◽  
Ali Jerjir ◽  
Peter Verelst ◽  
Marieke Devos ◽  
...  
Keyword(s):  
Case Reports ◽  
Gasserian Ganglion ◽  
Trigeminal Neuropathy

Chronic electrical stimulation of the gasserian ganglion for the relief of pain in a series of 34 patients

1997 ◽  
Vol 86 (2) ◽  
pp. 197-202 ◽  
Author(s):  
Ethan Taub ◽  
Michael Munz ◽  
Ronald R. Tasker
Keyword(s):  
Electrical Stimulation ◽  
Facial Pain ◽  
Prophylactic Antibiotic ◽  
Stage Ii ◽  
Gasserian Ganglion ◽  
Content Type ◽  
Antibiotic Drugs ◽  
Chronic Electrical Stimulation ◽  
Fine Print ◽  
Stimulation Of

✓ The use of an implanted system for chronic electrical stimulation of the gasserian ganglion for relief of facial pain was described in 1980 by Meyerson and Håkansson. Between 1982 and 1995, the senior author (R.R.T.) performed gasserian ganglion stimulation in 34 patients for the relief of chronic medically intractable facial pain. The etiology of pain was peripheral damage to the trigeminal nerve in 22 patients (65%), central (stroke) damage in seven (21%), postherpetic neuralgia in four (12%), and unclassifiable cause in one (3%). All patients received a trial of transcutaneous stimulation (Stage I). Successful trials in 19 patients (56%) were followed by implantation of a permanent system (Stage II). Trial and postimplantation stimulation were deemed successful when there was a reduction of pain by at least 50% whenever the stimulator was on. Success rates varied from five (71%) of seven patients for central pain to five (23%) of 22 for peripheral pain and none (0%) of four for postherpetic neuralgia. The median follow-up duration in successful cases was 22.5 months. Infections occurred in seven patients, all of whom had undergone Stage II treatment. Infections were more frequent when the stimulating electrode from Stage I was left in place for Stage II (six [43%] of 14) than when completely new hardware was used and prophylactic antibiotic drugs were administered (one [20%] of five). Other complications included iatrogenic injury to the trigeminal nerve or ganglion in three cases (9%), transient diplopia in two (6%), increased pain in two (6%), and various technical problems in 10 (29%). It is concluded that pain of central origin (stroke) is the type most likely to be relieved by this procedure. This finding is new, as the few other clinical series reported to date contain no patients with this type of pain. The risk of infection seems to be lower when completely new hardware is used for Stage II and prophylactic antibiotic drugs are administered.

Bilateral trigeminal amyloidoma: an unusual case of trigeminal neuropathy with a review of the literature

1994 ◽  
Vol 81 (5) ◽  
pp. 780-783 ◽  
Author(s):  
Terence J. O'Brien ◽  
Penelope A. McKelvie ◽  
Nikitas Vrodos
Keyword(s):  
Trigeminal Nerve ◽  
Unusual Case ◽  
Inflammatory Disorder ◽  
Gasserian Ganglion ◽  
Resonance Imaging ◽  
Trigeminal Neuropathy ◽  
Content Type ◽  
The Central Nervous System ◽  
Β Amyloid ◽  
The Brain

✓ Isolated amyloidomas may, albeit rarely, involve the central nervous system. There are three previous reports of amyloidomas that involved the gasserian ganglion and caused unilateral trigeminal neuropathies. The authors report the case of a 49-year-old woman with apparently isolated amyloidomas that caused slowly progressive bilateral trigeminal neuropathies. Magnetic resonance imaging of the brain revealed mild swelling of the left trigeminal nerve within the cavernous sinus and uniform enhancement with gadolinium throughout the length of the nerve. At craniotomy, the trigeminal nerve and ganglion were observed to be infiltrated by a tumor-like mass. Biopsy showed extensive infiltration of the nerve and ganglion by amyloid. Immunocytochemical studies of the amyloid were negative for immunoglobulins, κ and λ light chains, β-amyloid A4 protein, transthyretin, β2-microglobulin, cystatin C, and gelsolin, but weak focal immunoreactivity with antiamyloid AA antibody was seen in the amyloid in vessels and in some intraneural deposits. Extensive investigations failed to reveal evidence of either systemic amyloidoses or an underlying inflammatory disorder or malignancy.

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