• Title/Summary/Keyword: Pain: trigeminal neuralgia

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Clinical Considerations of Trigeminal Neuralgia (삼차신경통 진단 및 치료의 중요 고려사항)

  • Jeon, Young-Mi;Tae, Il-Ho;Choi, Jong-Hoon;Ahn, Hyung-Joon;Shim, Woo-Hyun;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.449-453
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    • 2007
  • Trigeminal neuralgia is defined as "a sudden, usually unilateral, brief stabbing recurrent pain in the distribution of one or more branches of the fifth cranial nerve" by the International Association for the Study of Pain(IASP). Trigeminal neuralgia is classified as an idiopathic trigeminal neuralgia with no apparent cause and a symptomatic trigeminal neuralgia which is caused by a structural lesion such as brain tumor. Over 80% of the tumors are meningioma, acoustic neuroma, and epidermoid tumors. Symptomatic trigeminal neuralgia can not be excluded even if old-aged patient does not have abnormal neurologic sign and symptom, and good response to pharmacotherapy. Therefore, initial examinations such as MRI or CT are essential to exclude symptomatic trigeminal neuralgia. When compared with CT, MRI, especially gadolinium enhanced MRI, has an increased sensitivity in the detection of intracranial lesions. The most effective medical treatment of trigeminal neuralgia is carbamazepine. The most common side effects of carbamazepine include drowsiness, dizziness, unsteadiness, nausea, anorexia. Hepatotoxicity, bone marrow depression are the most feared side effect of carbamazepine therapy but occurs rarely. It require periodic complete blood cell counts as well as hepatic and renal function tests. It has been recommended that complete blood cell counts is done every 2 weeks for the first 2months and then quaterly thereafter. Oxcarbazepine can be used if neutropenia occurs.

A Case Report of Trigeminal Neuralgia of Pregnant Soeumin Treated by Traditional Korean Medicine (한방치료로 호전된 소음인 임신부의 삼차신경통 치험 1례)

  • Lee, Ji-Yeon;Yoon, Soo-Hyeon;Cho, Hye-Sook;Jeon, Soo-Hyung;Lee, In-Seon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.2
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    • pp.121-130
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    • 2016
  • Objectives: The purpose of this study is to report the effect of Korean medical treatment on a patient with trigeminal neuralgia during pregnancy. Methods: We treated a facial pain patient diagnosed as trigeminal neuralgia during pregnancy with acupuncture, cupping and herbal medicines. Herbal medicines were prescribed according to the patient's Sasang constitution which was Soeumin. The severity of symptom was evaluated by Numeric Rating System (NRS). Results: After treatment, the patient's facial pain caused by trigeminal neuralgia was improved. NRS score was decreased from 6 to 0. Conclusions: This case report shows that traditional Korean medical treatment and Sasang constitution medicine is effective for the patient with trigeminal neuralgia during pregnancy.

A Clinical Report about Primary Trigeminal neuralgia patient (원발성 삼차신경통 환자 치험 1례)

  • Kim, Kyoung-Ok;Kim, Su-Youn
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.1
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    • pp.221-226
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    • 2005
  • The trigeminal neuralgia whose pain is led repeatedly and fitfully is limited inside the trigeminal nervous territory. The cause reveals so far clearly from the western medicine. According to this cause, the treatment is divided into surgical and non-surgical method. But the reduction of pain is not certificate and the case which concurs a sequela is many. So we made up to control typical primary trigeminal neuralgia by oriental medicine treatment like Herb Medication and A-Tx. In this case, patient is diagnosed 'Fire from stagnation of liver and stomach'(肝胃實熱)based on several symptoms. According to this, we used herbal medicine-chungpyesagantang-, and these efforts helped the case of disease.

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Linear Accelerator Radiosurgery for Trigeminal Neuralgia: Case Report (선형가속기를 이용한 삼차신경통의 정위적 방사선수술: 증례보고)

  • Yun Hyong-Geun
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.144-148
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    • 2006
  • Trigeminal neuralgia is defined as an episodic electrical shock-like sensation in a dermatomal distribution of the trigeminal nerve. When medications fail to control pain, various procedures are used to attempt to control refractory pain. Of available procedures, stereotactic radiosurgery is the least invasive procedure and has been demonstrated to produce significant pain relief with minimal side effects. Recently, linear accelerators were introduced as a tool for radiosurgery of trigeminal neuralgia beneath the already accepted gamma unit. Author have experienced one case with trigeminal neuralgia treated with linear accelerator. The patient was treated with 85 Gy by means of 5 mm collimator directed to trigeminal nerve root entry zone. The patient obtained pain free without medication at 20 days after the procedure and remain pain free at 6 months after the procedure. He didn't experience facial numbness or other side effects.

Maxillary Nerve Block for Patient with Trigeminal Neuralgia (삼차신경통환자의 상악신경 차단 -증례보고-)

  • Lim, Jung-Ae;Lee, Sang-Hun;Woo, Nam-Sik;Lee, Ye-Chul;Kim, Chan
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.303-306
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    • 1994
  • Trigeminal neuralgia is a unique disease entity to be dealt with at pain clinic due to it's severe pain attack. A 33-year old male patient had severe pain on left cheek area usually initiating from first upper molar tooth area for three years. We successfully treated this patient with maxillary nerve block using pure alcohol by a lateral approach. Three months after maxillary block the patient is still pain free.

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Secondary Trigeminal Neuralgia Caused by Pharyngeal Squamous Cell Carcinoma - A Case Report -

  • Kim, Min Seok;Ryu, Yong Jae;Park, Soo Young;Kim, Hye Young;An, Sangbum;Kim, Sung Woo
    • The Korean Journal of Pain
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    • v.26 no.2
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    • pp.177-180
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    • 2013
  • Trigeminal neuralgia (TN) is characterized by recurrent paroxysms of unilateral facial pain that typically is severe, lancinating, and activated with cutaneous stimulation. There are two types of TN, classical TN and atypical TN. The pain nature of classical TN are the same as those described above, whereas atypical TN is characterized by constant, burning pain. We describe the case of a 49-year-old male presenting with right-sided facial pain. The patient was diagnosed with temporomandibular joint disorder at a dental clinic and was on medical treatment, but his symptoms worsened gradually. He was referred to our pain clinic for further evaluation. Radiologic evaluation, including MRI, showed a parapharyngeal tumor. For the relief of TN, a right mandibular nerve (V3) root block was performed at our pain clinic, and then he was scheduled for radiation and chemotherapy.

A Study on the Clinical Feature and Treatment Outcome of Patients with Trigeminal Neuralgia (삼차신경통의 임상양태와 보존적 치료결과에 관한 연구)

  • Nam, Chang-Ok;Park, June-Sang;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.24 no.3
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    • pp.315-323
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    • 1999
  • The 63 patients(20 males, 43 females) were treated for their trigeminal neuralgia at the Department. of Oral Medicine, Pusan National University Hospital from 1993 to 1998. All the patients were treated for their trigeminal neuralgia by conservative methods such as medication, and Electric Acupuncture Stimulation Therapy The obtained results were as follows: 1. Trigeminal neuralgia was mainly involved in the patients of past forties, women and acute group. 2. 50.8% of patients were related to maxillary branches of trigeminal nerves. The trigger points were on gingivae, cheeks, teeth, lips in order. 3. 55.6% of patients with trigeminal neuralgia had systemic diseases and 39.7% were related to dental practices. 4. Success rate of the treatments was 71.4% and the recurrence rate was 26.3%. 5. The refractory factors in improving symptoms were chronic history, involvement of complex branches, and experience of prosthodontic treatments.

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Experience with Conventional Radiofrequency Thermorhizotomy in Patients with Failed Medical Management for Trigeminal Neuralgia

  • Singh, Sarita;Verma, Reetu;Kumar, Manoj;Rastogi, Virendra;Bogra, Jaishree
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.260-265
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    • 2014
  • Background: To evaluate the results of conventional radiofrequency thermorhizotomy (CRT) for trigeminal neuralgia (TN) in patients with failed medical management. Methods: Patients with Trigeminal neuralgia who were referred to us for 'limited intervention' during the time frame July-2011 to Jan-2013 were enrolled for this study. CRT was administered by the Sweet technique. Pain relief was evaluated by the principle investigator. Results: Eighteen patients were enrolled and completed a mean follow-up of 18.0 months. Pain relief was observed in 14 of 18 (77.8%) patients on the post-operative day, 14 of 18 (77.8%) at 1-month follow-up, 14 of 17 (82.4%) at 3-months follow-up, 12 of 15 (80%) at 6-months follow-up, 7 of 11 (63.6%) at 1-year follow-up and 2 of 6 (33.3%) 1.5 years of follow-up. Four patients required a repeat cycle of CRT; two at six months of follow-up and two at one year of follow-up. One patient was transferred for surgical intervention at six months of follow-up. Side-effects included facial hypoesthesia (n = 6); nausea/vomiting (n = 2), diminished corneal reflex (n = 13) and difficulty in chewing (n = 11). Severity of adverse effects gradually diminished and none of the patients who are beyond 6 months of follow-up have any functional limitation. Conclusions: CRT is an effective method of pain relief for patients with Trigeminal neuralgia. Successful outcome (excellent or good) can be expected in 66.7% of patients after first cycle of CRF. The incidence and severity of adverse effects is less and the procedure is better tolerated by the patients.

Trigeminal Neuralgia Patient who has Contralateral Hemifacial Spasm -A case report- (삼차신경통과 반대측 안면경련이 동반된 환자의 치료 경험 -증례 보고-)

  • Kim, Chan;Kim, Seong-Mo;Lee, Hyo-Keun;Hyang, Hyuk-Yi;Kim, Seung-Hee;Lee, Young-Chul;Kim, Bu-Seong;Cho, Young-Rye
    • 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.

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The clinical observation on I case of patient with trigeminal neuralgia (삼차신경통(三叉神經痛) 환자 1례(例)에 대한 증례보고(證例報告))

  • Kim, Ji-Hyoung;Chung, Seung-Hyun;Shin, Gil-Jo;Lee, Won-Chul;Cho, Gyu-Seon
    • The Journal of Internal Korean Medicine
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    • v.21 no.3
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    • pp.505-510
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    • 2000
  • In the treatment of trigeminal neuralgia, it is known that the operative mothods, such as neurovascular decompression, rhizotomy etc. are the most effectious therapies on its pain control. But, due to some side effects and complication, the healing by the first intention of trigeminal neuralgia has been the pharmacotherapy. The cabamazepine is the most common agent, but it is not often effectious in some cases, and attenuated as time goes, engaged in some symptoms, such as dizziness, nausea, vomit, etc., and caused in aplastic anemia, thus it has much deficacies in being the first intention. Recently we have experienced a 77-year old woman who had suffered from the severe trigeminal neuralgia for 21 years, and her condition and pain control were improved through the Korean medical treatments, so we report it for the better treatment.

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