Stereotactic Gamma Ray Radiosurgery to the Centromedian and Parafascicular Complex of the Thalamus for Trigeminal Neuralgia and Other Complex Pain Syndromes

Anatomy and physiology of pain 186 Anatomy and physiology of oro-facial pain 187 Oro-facial (idiopathic) pain syndromes 188 Overview of oro-facial pain 190 Assessment and measurement of pain 192 Temporomandibular dysfunction (TMJPDS) 196 Atypical facial pain 202 Trigeminal neuralgia ('tic douloureux') 204 Glossopharyngeal neuralgia 206...

Download Full-text

“SUNCT” Syndrome. A Case of Transformation from Trigeminal Neuralgia?

Cephalalgia ◽

10.1046/j.1468-2982.1994.1402168.x ◽

1994 ◽

Vol 14 (2) ◽

pp. 168-170 ◽

Cited By ~ 55

Author(s):

D Bouhassira ◽

N Attal ◽

M Estève ◽

M Chauvin

Keyword(s):

Trigeminal Neuralgia ◽

Facial Pain ◽

Sunct Syndrome ◽

Pain Syndromes ◽

Close Relationship

A patient with typical trigeminal neuralgia involving the first branch of the nerve developed short-lasting unilateral attacks in the same area which were associated with severe vasomotor phenomena consistent with the recently described SUNCT syndrome. This evolution suggests that SUNCT might correspond, at least in this case, to a “transformed” trigeminal neuralgia and emphasizes the close relationship between these unilateral facial pain syndromes.

Download Full-text

Trigeminal Neuropathic Pain

Pain Neurosurgery ◽

10.1093/med/9780190887674.003.0005 ◽

2019 ◽

pp. 31-40

Author(s):

Mandana A. Behbahani ◽

Nauman S. Chaudhry ◽

Konstantin V. Slavin

Keyword(s):

Neuropathic Pain ◽

Trigeminal Neuralgia ◽

Facial Pain ◽

Pulse Generator ◽

Unintentional Injury ◽

Pain Syndrome ◽

Management Process ◽

Trigeminal Neuropathic Pain ◽

Pain Syndromes ◽

Internal Pulse Generator

Trigeminal neuropathic pain (TNP) involves pain isolated to the distribution of one or more branches of the trigeminal nerve following unintentional injury to that nerve. It is important to distinguish this facial pain syndrome from trigeminal neuralgia, as the treatment is quite different. The diagnosis is typically clinical, although local anesthetic blocks may aid in the diagnosis. Psychological testing is often performed preoperatively. Like other neuropathic pain syndromes, TNP may be treated with peripheral nerve stimulation. This chapter discusses a typical presentation of TNP, as well as the evaluation and management process, including placement of subcutaneous electrodes and connection to an internal pulse generator.

Download Full-text

Idiopathic Trigeminal Neuralgia in the Healthy Patient

Pain Neurosurgery ◽

10.1093/med/9780190887674.003.0001 ◽

2019 ◽

pp. 1-8

Author(s):

Oren Sagher

Keyword(s):

Health Status ◽

Trigeminal Neuralgia ◽

Microvascular Decompression ◽

Treatment Options ◽

Pain Syndrome ◽

Operative Management ◽

Differential Diagnoses ◽

Healthy Patient ◽

Pain Syndromes ◽

Idiopathic Trigeminal Neuralgia

Abstract: Idiopathic trigeminal neuralgia is one of the most common pain syndromes encountered in a typical neurosurgical practice. The approach to these patients is nuanced, and is based on their overall health status, the characteristics of their pain, and the distribution of symptoms. This chapter describes the assessment of a healthy patient with trigeminal neuralgia and provides key differential diagnoses of this pain syndrome. The counseling of the patient regarding treatment options is also described. Finally, the chapter outlines the operative management of a healthy patient using a microvascular decompression (MVD), including surgical pearls and strategies for complication avoidance and management.

Download Full-text

Neuropathic pain

10.1093/med/9780199664368.003.0005 ◽

2016 ◽

Author(s):

Sathiji Nageshwaran ◽

Heather C Wilson ◽

Anthony Dickenson ◽

David Ledingham

Keyword(s):

Neuropathic Pain ◽

Trigeminal Neuralgia ◽

Diabetic Neuropathy ◽

Clinical Features ◽

Phantom Pain ◽

Evidence Based ◽

Post Herpetic Neuralgia ◽

Central Neuropathic Pain ◽

Pain Syndromes

This chapter on neuropathic pain discusses the classification, clinical features, and evidence-based management of major neuropathic pain syndromes (painful polyneuropathy, diabetic neuropathy, post-herpetic neuralgia, HIV neuropathy, cancer neuropathic pain, phantom pain, traumatic neuropathic pain, chronic radiculopathy, central neuropathic pain, and trigeminal neuralgia).

Download Full-text

Extensive Craniocervical Abscess after Transoral Ganglionic Local Opioid Analgesia at the Superior Cervical Ganglion for Atypical Trigeminal Neuralgia: Report of a Severely Complicated Case

Case Reports in Medicine ◽

10.1155/2018/5247594 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Christoph Sproll ◽

Bernd Turowski ◽

Rita Depprich ◽

Norbert R. Kübler ◽

Marion Rapp ◽

...

Keyword(s):

Trigeminal Neuralgia ◽

Superior Cervical Ganglion ◽

Low Dose ◽

Craniocervical Junction ◽

Opioid Analgesia ◽

Face Region ◽

Pain Syndromes ◽

Cervical Ganglion ◽

Safe Technique

Ganglionic local opioid analgesia (GLOA) describes the application of low-dose opioids close to sympathetic as, for example, to the superior cervical ganglion. GLOA can be effective in different pain syndromes affecting the head and face region and has been considered to be a safe technique with few complications reported so far. We present the case of a patient who received a single, transoral GLOA for a refractory trigeminal neuralgia. The patient subsequently developed an extensive epidural abscess at the craniocervical junction, requiring ultimately transoral odontoid resection and dorsal stabilisation. This severe complication challenges the role of transoral infiltration therapies in analgetic medicine.

Download Full-text