• Title/Summary/Keyword: trigeminal neuralgia(三叉神經痛)

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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.

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.

Alcohol Neurolysis for the Treatment of Trigeminal Neuralgia (Alcohol Neurolysis를 이용한 삼차 신경통 치험예)

  • Choe, Huhn
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.45-48
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    • 1989
  • Trigeminal neuralgia is one of the diseases which cause most chronic and intractable pain on the facial area. Several drugs includding analgegics, anticonvulsants, tranquilizers, vitamins or hormonal preparations have been expected to be effective but no drug could effectively relieve the patients from the pain. The pain could be relieved by surgical neurectomy or neurolysis of the Gasserian ganglion or the involved branches with absolute alcohol alternatively. Surgical microvascular decompression may be performed if the pain resulted from compression of the nerve by adjucent arterial loops. 4 cases of trigeminal neuralgia are presented. They were treated with alcohol neurolysis of the involved peripheral nerves combined with or without carbamazepine and/or amitriptyline with favorable result of pain relief.

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Two Cases Report of Galgunhaegui-tang Applied on Trigeminal neuralgia (삼차신경통(三叉神經痛)에 갈근해기탕(葛根解肌湯)을 사용한 임상증례 2례)

  • Jo, Joon-Ki;Seong, Eun-Jin;Youn, In-Hwan;Hong, Seok-Hoon;Park, Min-Cheol
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.20 no.3
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    • pp.243-250
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    • 2007
  • Trigeminal neuralgia is nerve systematic disease appearing in the distribution scope of trigeminal nerve. It's characterized by extreme pain accompanying with a repeated and simultaneous fit from several seconds to 1-2 minutes. The oriental medical name of trigeminal neuralgia is generally Dootong, Doopoong, Myuntong, Pyundootong, Pyundoopoong, and Myuntong is the nearest in Occidental medicine. So I study for general prescription of Trigeminal neuralgia and point out Galgunhaegui-tang(葛根解肌湯). Trigeminal neuralgia patients were given Galgunhaegui-tang. After taking Galgunhaegui-tang, the patients's Trigeminal neuralgia was improved.

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Outcome of Gamma Knife Radiosurgery for Trigeminal Neuralgia (삼차신경통에 대한 감마나이프방사선 수술)

  • Jeon, Sang Ryong;Lee, Dong Joon;Kim, Jeong Hoon;Kim, Chang Jin;Kwon, Yang;Lee, Jung Kyo;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1228-1232
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    • 2000
  • Objective : This study was undertaken to analysis gamma knife radiosurgery(GKR) effect for trigeminal neuralgia after long term follow-up. Methods : There were 11 trigeminal neuralgia patients. The authors irradiated 67-85 Gy maximally to the nerve root entry zone(NREZ) using single 4mm collimator, just 1-6mm lateral side from the junction of the trigeminal nerve and pons. For the first 3 cases, we targeted the junction between the nerve and the pons. In theses cases, the pons was irradiated 56 or 60 gray in the surface. In the later 8 cases, the isocenter is positioned more distal side so that the brain stem surface would receive less than the 20% isodose. Results : The average follow-up duration was 25 months(13-50 months). Pain relief was noticed within a week to 5 months. In 3 patients, pain was relieved completely and in other 3 patients, mark improvement was achieved(80-90%). Remaining 4 patients showed significant improvement(30-50%). There was recurrence in only one case and she complained with similar intensity of pain at the last follow-up. There was no significant complication related to GKR. Conclusion : GKR is considered effective for trigeminal neuralgia based on the long term follow-up evaluation, but more clinical experience is needed to evaluate the efficacy of GKR for trigeminal neuralgia as a primary treatment modality.

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A Case of Secondary Trigeminal Neuralgia Caused by Infected Postoperative Maxillary Cyst (술후상악낭종 환자에서 삼차신경통이 유발된 증례 1례)

  • Lee, Sang Min;Sung, Han Kyung;Kang, Ju Chang;Kim, Hong Joong
    • Journal of Rhinology
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    • v.25 no.2
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    • pp.114-117
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    • 2018
  • Postoperative maxillary cyst (POMC) is relatively common complication among patients who underwent Caldwell-Luc surgery. Patients with POMC usually have no symptoms, although cyst extension can result in bone destruction or cystic infection with pain. The trigeminal nerve consists of the ophthalmic nerve, maxillary nerve, and mandibular nerve. Among these branches, the maxillary nerve runs to the lateral and frontal sides of the maxillary sinus wall. POMC can rarely lead to trigeminal neuropathy caused by cyst enlargement that compresses some branches of the trigeminal nerve. Recently, we experienced a case with trigeminal neuralgia due to POMC. The patient was successfully treated with inferior meatal antrostomy. We report this rare case with a literature review.

Bilateral Trigeminal Neuralgia -Four cases- (양측성 삼차신경통 -증례 보고-)

  • Kim, Chan;Park, Soo-Kyung;Han, Kyung-Lim;Ock, Kyung-Jong;Lee, Ji-A;Kim, Jin-Soo;Yoon, Seok-Whan
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.232-236
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    • 2000
  • Bilateral trigeminal neuralgia is uncommon and usually occurs in 1% to 11% of patients with trigeminal neuralgia. There has been no report of a patient with bilateral trigeminal neuralgia in Korea. Based on our review, the incidence of bilateral trigeminal neuralgia among the trigeminal neuralgia patients who visited our pain clinic numbered 0.7% (4 out of 531). This is much lower than those of other previous studies. This lower incidence might be explained by the fact that we excluded those patients with mild bilateral trigeminal neuralgia which did not require treatment and also patients whose symptom on controlateral side was relieved by injection of local anesthetics for that side. Among the four patients with bilateral trigeminal neuralgia, three patients received alcohol block of the branches of trigeminal nerve and one refused the treatment. Overall, three patients maintained good or excellent pain relief without any serious complications throughout the follow-up period.

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A Case Report of Trigeminal Neuralgia in a Patient with Systemic Sclerosis Improved by Korean Medicine Treatment (한의 치료로 호전된 전신경화증 환자의 삼차신경통 치험 1례)

  • Jeong-Hwa Oh;Hwa-Jung Yoon
    • Journal of TMJ Balancing Medicine
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    • v.13 no.1
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    • pp.32-38
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    • 2023
  • Objectives: The purpose of this study is to report the effect of Korean medicine on trigeminal neuralgia in a patient with systemic sclerosis. Methods: We treated a 49-year-old male patient who has systemic sclerosis and trigeminal neuralgia by Korean medicine. He was treated from October 29th, 2022 to November 12th, 2022. The treatment applied was herbal medicine, acupuncture, pharmacopuncture. The evaluation was conducted by Visual Analogue Scale (VAS). Results: After 14 days of treatment, the symptoms were alleviated. Facial pain and dullness of taste improved. VAS of discomfort was decreased from 10 to 2. Conclusions: These results showed that Korean medicine may have an effect on reducing symptoms of systemic sclerosis and trigeminal neuralgia.

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