Microsurgical Approach to the Trigeminal Nerve for Tic Douloureux

2015 ◽  
pp. 180-200 ◽  
Author(s):  
Peter J. Jannetta
Keyword(s):  
Trigeminal Nerve ◽  
Tic Douloureux ◽  
Microsurgical Approach

A Comparison of Percutaneous Radiofrequency Trigeminal Neurolysis and Microvascular Decompression of the Trigeminal Nerve for the Treatment of Tic Douloureux

Neurosurgery ◽  
1977 ◽  
Vol 1 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Ronald I. Apfelbaum
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Microvascular Decompression ◽  
Sensory Loss ◽  
Tic Douloureux ◽  
Suboccipital Craniectomy ◽  
Early Results ◽  
Classical Trigeminal Neuralgia

Abstract In a 36-month period, 103 consecutive patients have been treated for classical trigeminal neuralgia with either percutaneous radiofrequency trigeminal neurolysis (PTN) (48 patients) or microvascular decompression (MVD) via a suboccipital craniectomy (55 patients). The results of these two procedures are tabulated, emphasizing especially the complications that have occurred with each. Successful initial relief of pain was achieved in 88% of the patients with PTN and 96% of the patients with MVD. Two significant complications occurred in the former group. Severe recurrences have occurred to date in 13% of the patients with PTN and in 5% of those with MVD. It is concluded that both procedures are effective, but that microvascular decompression offers the advantage of avoiding sensory loss and associated dysesthetic sensations. Follow-up is too short to conclude that MVD is a curative procedure, but the early results are very encouraging.

Trigeminal Neuralgia Secondary to a Tentorial Ossification: A Case Report

Neurosurgery ◽  
1982 ◽  
Vol 11 (4) ◽  
pp. 527-529 ◽  
Author(s):  
Michael Standefer ◽  
Janet W. Bay ◽  
Donald F. Dohn
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Posterior Fossa ◽  
Trigeminal Nerve ◽  
Facial Pain ◽  
Atypical Facial Pain ◽  
Tic Douloureux ◽  
Sensory Root ◽  
Unusual Symptoms

Abstract The authors describe a patient who suffered from tic douloureux associated with atypical facial pain and tinnitus. All preoperative neurodiagnostic findings were normal. Posterior fossa exploration disclosed a tentorial ossification compressing the sensory root of the trigeminal nerve. Ossification within the tentorium and the implications of unusual symptoms associated with trigeminal neuralgia are discussed.

The Cluster-Tic Syndrome and Its Surgical Therapy

Cephalalgia ◽  
1985 ◽  
Vol 5 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Seymour Solomon ◽  
Ronald I Apfelbaum ◽  
Karen M Guglielmo
Keyword(s):  
Cluster Headache ◽  
Facial Nerve ◽  
Blood Vessels ◽  
Surgical Therapy ◽  
Trigeminal Nerve ◽  
Similar Condition ◽  
Tic Douloureux ◽  
Pain Pattern ◽  
Clinical Pain

The term cluster-tic syndrome (CTS) is used to designate a clinical pain pattern in which symptoms of cluster headache (CH) and tic douloureux (TD) coexist. The TD elements of the attack occur in paroxysms of many seconds or minutes, always affect the maxillary or mandibular divisions of the trigeminal nerve, with spread into the ophthalmic division in some cases, and may be triggered by slight superficial stimuli. These features may occur independent of CH elements but more often the two blend together. Four patients with CTS unresponsive to medication underwent surgery. Blood vessels were found to cross compress the trigeminal nerve in all four patients and the nerve was decompressed. A similar condition was found affecting the facial nerve in two of the three patients in whom that nerve was explored and the facial nerve was decompressed in these two. The TD component of the CTS disappeared after surgery in all four patients. The CH component of the syndrome returned after surgery but in a modified form. In three patients, the CH changed from what had been chronic cluster to infrequent episodic cluster periods; additionally in two patients, the duration of cluster was shorter and the pain was of lesser severity.

Chronic Paroxysmal Hemicrania-Tic Syndrome

Cephalalgia ◽  
1998 ◽  
Vol 18 (3) ◽  
pp. 159-161 ◽  
Author(s):  
AB Caminero ◽  
JA Pareja ◽  
JL Dobato
Keyword(s):  
Trigeminal Neuralgia ◽  
Female Patient ◽  
Clinical Features ◽  
Trigeminal Nerve ◽  
Paroxysmal Hemicrania ◽  
Tic Douloureux ◽  
Chronic Paroxysmal Hemicrania ◽  
Orbital Region

We report the coexistence of both chronic paroxysmal hemicrania (CPH) and trigeminal neuralgia (tic douloureux) in a female patient. The clinical features combined to make a configuration of CPH-tic syndrome. The two components of the syndrome appeared synchronously in the same orbital region—first branch of the trigeminal nerve—with a latency of several years after the onset of isolated tic attacks of the second and third trigeminal divisions. The concurrence of both types of pain in the same symptomatic area may have some significance for pathogenic, clinical, and pharmacological aspects of such a syndrome. We discuss all these and postulate a provisional distinction between CPH-V2,3 tic and CPH-V1 tic.

scholarly journals INFERIOR ALVEOLAR NERVE RADIOFREQUENCY ABLATION FOR REFRACTORY TRIGEMINAL NEURALGIA: A CASE REPORT

2019 ◽  
pp. 49-54
Author(s):  
Devang Padalia
Keyword(s):  
Radiofrequency Ablation ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Negative Impact ◽  
Inferior Alveolar Nerve ◽  
Tic Douloureux ◽  
Patient Reported ◽  
Significant Negative Impact ◽  
Mandibular Region ◽  
Key Words Trigeminal Neuralgia

Trigeminal neuralgia, also known as tic douloureux, is a disorder characterized by pain in the distribution of the trigeminal nerve. Chronic pain secondary to this condition can have a significant negative impact on a patient’s quality of life. We present an educational case of refractory trigeminal neuralgia responsive to a novel painalleviating procedure. An 80-year-old man with recurrent trigeminal neuralgia presented with episodic pain refractory to multimodal pharmacologic treatment, as well as interventional pain procedures. Radiofrequency ablation (RFA) to the mandibular and maxillary branches of the trigeminal nerve was attempted, but deemed unsuccessful. In an attempt to relieve the patient’s pain in the mandibular region, an inferior alveolar nerve block with radiofrequency ablation was performed. The patient reported a significant longterm reduction of his pain and improved ability to perform activities of daily living. Key words: Trigeminal neuralgia, tic douloureux, radiofrequency ablation, trigeminal nerve, inferior alveolar nerve

Comparison of Percutaneous Radiofrequency Gangliolysis and Microvascular Decompression for the Surgical Management of Tic Douloureux

Neurosurgery ◽  
1981 ◽  
Vol 9 (2) ◽  
pp. 111-119 ◽  
Author(s):  
Kim J. Burchiel ◽  
Timothy D. Steege ◽  
John F. Howe ◽  
John D. Loeser
Keyword(s):  
Pain Relief ◽  
Trigeminal Nerve ◽  
Microvascular Decompression ◽  
Pathological Condition ◽  
Entire Group ◽  
Tic Douloureux ◽  
Risk Of Mortality ◽  
Bony Prominence ◽  
Time Of Operation

Abstract Forty-two patients with tic douloureux underwent posterior fossa craniectomy and microvascular decompression (MVD) or partial rhizotomy of the trigeminal nerve and were followed an average of 25 months after operation. Thirty-six patients were found to have anatomical distortion of the nerve by an artery, vein, bony prominence, or a combination of factors, and 30 patients (83%) of this group have remained pain-free postoperatively. Six patients had no discernible pathological condition at the time of operation and underwent partial trigeminal rhizotomy. No patient underwent repeated MVD or rhizotomy, although 4 patients whose pain recurred after MVD underwent rhizotomy at a second operation. Eight of the 10 patients treated by rhizotomy are currently pain-free. The overall success rate of the entire group is 90%~2% experienced a complication, and there was 1 perioperative death. Seventy-eight patients with tic douloureux who underwent 92 percutaneous radiofrequency trigeminal gangliolysis (PRTG) procedures were evaluated an average of 56 months postoperatively. Sixty-eight per cent of these patients when evaluated 1 year postoperatively were pain-free. However, only 35% of the PRTG procedures resulted in continued pain relief 5 years after operation. Twelve of the 78 patients (15%) required repeat gangliolysis because of recurrent tic pain. Considering all 78 patients treated with 92 PRTG procedures, 64% were pain-free at follow-up examination. PRTG was associated with an 8% risk of complications, which included anesthesia dolorosa, corneal anesthesia with keratitis, and significant facial paresthesias. Both PRTG and MVD have advantages. MVD should be considered because: (a) it attacks what is believed to be the primary etiology of tic douloureux, (b) the trigeminal nerve is preserved, (c) postoperative pain relief does not depend upon the production of sensory deficit, and (d) it may have a greater potential for producing long-lasting pain relief. However, PRTG has other advantages: (a) it avoids the risks of craniectomy, (b) it is repeated easily if tic pain recurs, (c) morbidity is minimal and therde is essentially no risk of mortality, and (d) it is much less expensive.

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