• The Korean Journal of Pain
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• v.22 no.2
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• pp.167-170
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• 2009

Pharmacological management is the first choice for treatment of the trigeminal neuralgia patients; however, if this mode of treatment fails a minimally invasive procedure should be performed. One of the most commonly used procedures is conventional radiofrequency lesioning of the Gasserian ganglion. Despite its popularity and success rate, this technique has disadvantages such as diminished corneal reflex, masseter weakness, numbness and anesthesia dolorosa. As a result, many studies have been conducted in an attempt to find a better method of treating trigeminal neuralgia. We report here a case of a trigeminal neuralgia patient that was treated with pulsed radiofrequency lesioning of the supraorbital and supratrochlear nerve due to pain in the frontal head that was refractory to the pharmacological treatments. Following the procedure, the Visual Analogue Scale score for pain decreased to 1-2/10 and the pain relief persisted for 7 months. These results indicate that pulsed radiofrequency treatment of the peripheral nerve may be useful for trigeminal neuralgia patients that do not respond to pharmacological treatments.

• Journal of Korean Neurosurgical Society
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• v.30 no.2
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• pp.186-193
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• 2001

Objectives : Trigeminal neuralgia and hemifacial spasm are caused by vascular compression of the REZ(root entry or exit zone) of the 5th and the 7th cranial nerve. Preoperative detection of neurovascular compression is essential for accurate diagnosis, appropriate treatment, and the good operative results. Three dimensional Fourier Transformation-Constructive Interference in Steady State(3DFT-CISS) images are known to give good contrast between CSF, nerve, and vessels. We applied a 3DFT-CISS imaging technique for the preoperative evaluation of patients with these diseases and estimated the diagnostic accuracy and usefulness of this study. Methods : A series of 71 patients with trigeminal neuralgia and hemifacial spasm were treated by microvascular decompression. Among them 34 patients with trigeminal neuralgia and 24 patients with hemifacial spasm had preoperative CISS images. We compared the radiologic finding with the operative finding, and analysed the diagnostic usefulness of 3DFT-CISS imaging. Results : The sensitivity of CISS images of detecting the neurovascular compression was 90.3% in trigeminal neuralgia and 100% in hemifacial spasm. There were one false-positive and three false-negative cases in trigeminal neuralgia, and one false-positive case in hemifacial spasm. The accuracy in diagnosing the causative vessel was 73.5% in trigeminal neuralgia and 83.3% in hemifacial spasm. Conclusion : CISS image is very useful diagnostic tool for preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia and hemifacial spasm. No additional neuroradiologic examination other than CISS image and MRA is needed for preoperative evaluation of patients with trigeminal neuralgia and hemifacial spasm.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.423-425
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• 1996

Tic convulsif is a syndrome restricted to paroxysmal dysfunction of the fifth and seventh cranial nerves. It occurs predominantly in women over the age of 50 years and is usually associated with an ectatic vertebrobasilar artery - less frequently an arteriovenous malformation or cholesteatoma - which compresses the trigeminal and facial nerve roots in the postetior fossa. In rare instances this syndrome may be caused by brain tumor. Because of the high incidence of posterior fossa lesions in painful tic convulsif, a complete neurological evaluation including computerised transaxial tomography should be performed in every case. We experienced a case of trigeminal neuralgia(mandibular division)and contralateral hemifacial spasm.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.119-123
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• 1998

It is well known that many patients with trigeminal neuralgia suffer from electric shock-like stabbing pains. The pain can be triggered by nonnoxious stimuli such as touching of the face, chewing, talking or swallowing. This 62 year old woman was urgently admitted to the internal medicine department due to abdominal distention and severe general weakness. She has suffered characteristic violent pain triggered by chewing and swallowing for little over 4 years. This resulted in poor oral feeding for prolonged period which left her severely debilitated. The large amount of ascites that developed 20 days before admission and extreme emaciation forced her to bed rest. She also suffered from Herpes Zoster. After medical treatment to improve liver function and severe pain was persisted, the patient was referred to our department for control of pain. We performed right mandibular block with 1% dibucaine 0.4 ml and the effect was excellent. After the pain had subsided, patient was able to take meals more comfortably and improved liver function returned.

• The Korean Journal of Pain
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• v.22 no.3
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• pp.241-244
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• 2009

Retrobulbar hematoma can arise from orbital trauma and periorbital or intraorbital procedures, and it can result in several morbidities including vision loss. Making the immediate diagnosis and performing decompression of the retrobulbar hematoma are crucial for preventing serious morbidities such as permanent vision loss. We present here a case of temporary vision loss that was due to iatrogenic retrobulbar hematoma in a patient who received infraorbital nerve block for the treatment of trigeminal neuralgia. A 70-year-old woman with trigeminal neuralgia was treated with infraorbital nerve block. Just after the procedure she experienced acute periorbital swelling, proptosis and worsening visual acuity. Immediate orbital computed tomography was done, and this revealed a retrobulbar hematoma. The patient underwent lateral canthotomy with cantholysis and administration of dexamethasone and mannitol. Improvement of visual acuity began 3 hours after these procedures. Her visual acuity was greatly improved 12 days after admission.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.2
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• pp.102-108
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• 2016

Headache disorders, one of most common disease in general population, have been developed according to many versions of international classifications. The primary headaches are those in which no consistently identified organic cause can be determined. It is divided into the following categories: (1) migraine, (2) tension-type headache, (3) cluster headache and other trigeminal autonomic cephalalgias, (4) other primary headaches. This review described a diagnosis of primary headache disorders based on International Classification of Headache Disorders (ICHD)-3 beta criteria.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.83-88
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• 1996

This is a retrospective analysis of 158 patients who visted our Neuro-Pain clinic, April 1992 to March 1996, suffering from trigeminal neuralgia. Most patients received nerve blocks in its triggering peripheral branches of pain. All patients experienced pain relief for 3 months after initial successful nerve block. Twenty two patients complained of recurring pain within 4 to 32 months. Mean duration of pain relief was as follows: infraorbital nerve block 15.2 months, maxillary nerve block 16.8 months, and mandibular nerve block 23.4 months. Demographic and clinical characteristics of all patients were also evaluated. This study demonstrates that alcohol block is a safe and effective method of treating trigeminal neuralgia.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.371-373
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• 1995

Percutaneous retrogasserian gangliolysis is suitable for treatment of trigeminal neuralgia because it is simple and effective. Further, it can avoid severe complications such as anesthesia dolorosa or dysesthesia that may develop after surgical procedure. However we have experienced an anesthesia dolorosa(pain in an area or region that is anesthetic) after percutaneous retrogasserian glycerol injection. This deafferentation pain is characterized by scratching, burning or itching sensation; and has shown to be of higher incidence in older and inemotionally unstable patients. Anesthesia dolorosa is relatively rare but difficult to treat. Consideration should be made for the complication which may develop during the procedure.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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• pp.249-256
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• 1998

Glial fibrillary acidic proteins (GFAP) are a group of intermediate filaments that are distributed in the cytoplasm of glial cells. GFAP immunoreactivity (GFAP-IR) increase after central and peripheral nerve injuries. The purpose of this study was to determine change of GFAP-IR in rat trigeminal ganglion satellite cells following the axotomy of inferior alveolar nerve(IAN). The immunohistochemistry was carried out using the avidin-biotin-peroxidase complex(ABC) method. 1. Control group : Astrocytes in central root of trigeminal ganglion had strong GFAP-IR, but satellite cells of trigeminal ganglion occasionally had GFAP-IR. The patterns of reactivity in satellite cells of trigeminal ganglion were not concenturated in any specific region of trigeminal ganglion. 2. Three day group after IAN axotomy : There were highly GFAP-IR in satellite cells of trigeminal ganglion in mandibular region. GFAP-IR in maxillary and ophthalmic regions were less intense compared to mandibular region. 3. Seven day group after IAN axotomy : GFAP-IR that were increased compared to control group were seen in the mandibular region. But GFAP-IR were less intense compared to three day group. These results suggest that GFAP-IR increase in specific region of trigeminal ganglion following peripheral axotomy. therefore we suppose that GFAP study offer research tool in trigeminal neuralgia.

• Journal of Sasang Constitutional Medicine
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• v.33 no.4
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• pp.23-31
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• 2021

Objective The case report showed that sudden hearing loss and tinnitus after trigeminal schwannoma surgery were improved with Yeoldahansotang-gamibang. Method The patient was diagnosed with Taeeumin interior heat (Ganyeol) disease based on the original symptoms of Taeeumin. He was treated with herbal medicine and acupuncture treatment. Puretone audiometry (PTA), speech audiometry, tinnitus handicap inventory (THI) and the original symptoms were investigated before and after the treatment. Results Right side PTA score was significantly reduced, speech audiometry was improved in speech reception threshold (SRT), word recognition score (WRS) and most comfortable level (MCL) and THI score decreased from 40 to 0, which showed normalizing hearing function. And the patient revealed improvements in sleeping, digestion, stooling, perspiration and facial sensation after treatment. Conclusion This study suggests that Yeoldahansotang-gamibang is effective on sudden hearing loss and tinnitus after surgery by correcting the imbalanced energy of Taeeumin.