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Inflammatory Disorders of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Trigeminal neuralgia: Gabapentin, 300 mg two times or three times daily, increasing as needed; pregabalin is also useful.Carbamazepine 200–400 mg three times daily.Baclofen 10–20 mg three times daily.Sodium valproate.
Central nervous system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
MRI is superior to CT in the exclusion of SOLs, and has much greater sensitivity and accuracy in evaluation of white matter lesions and distribution of disease [30–32]. All of the cranial nerves can be directly visualised by MRI, with the second, fifth, seventh and eighth being routinely visualised, although the trochlear nerve (IV) can be difficult to identify. Inflammatory diseases and tumours of the optic nerve can be characterised (see Orbits and eyes). The cause of trigeminal neuralgia can often be elicited particularly where the cause is vascular compression [33] or tumour.
Trigeminal nerve – interdisciplinarity between the areas of dentistry and audiology
Published in J. Belinha, R.M. Natal Jorge, J.C. Reis Campos, Mário A.P. Vaz, João Manuel, R.S. Tavares, Biodental Engineering V, 2019
Fernanda Gentil, J.C. Reis Campos, Marco Parente, C.F. Santos, Bruno Areias, R.M. Natal Jorge
Trigeminal neuralgia is a neuropathic pain sudden and abrupt of the face. Often felt like a shock or shot along the course of the affected nerve. The pain usually involves the lower part of the face and jaw, but the symptoms can appear near the nose, ears, eyes or lips.
The pharmacological management of dental pain
Published in Expert Opinion on Pharmacotherapy, 2020
Joseph V. Pergolizzi, Peter Magnusson, Jo Ann LeQuang, Christopher Gharibo, Giustino Varrassi
Cluster headaches and migraine headaches are neurovascular events that may sometimes present with dental pain. Neurovascular headaches may refer pain to the teeth and the patient may present with headache or toothache or both together; these are known as neurovascular toothaches. The headache causes neuropeptides to be released from the trigeminal nerve endings in the intracranial blood vessels to dilate and the resulting inflammation and pressure cause pain. In cases of a suspected referred toothache, it may be useful to ask the patient about headache status. Treatment of the headache may relieve pain and an NSAID can be used to reduce the dental inflammation [73]. Cluster headache is often treated with oxygen and migraine may be treated with any of several pharmacological treatments (calcitonin gene-related peptide inhibitors, Botox, opioids, acetaminophen/caffeine, and others). If dental pain resolves with headache treatment, it suggests that the toothache was neurovascular. In the same way, trigeminal neuralgia may present with excruciating sharp or shooting pains in the teeth or oral cavity. Treatment of the trigeminal neuralgia (carbamazepine) may improve symptoms, but dental blockade will not [66].
The expression of voltage-gated sodium channels in trigeminal nerve following chronic constriction injury in rats
Published in International Journal of Neuroscience, 2019
Mingxing Liu, Jun Zhong, Lei Xia, Ningning Dou, Shiting Li
Trigeminal neuralgia is a form of neuropathic pain usually described by the patients as an unbearable, excruciating discomfort, sometimes severe enough to lead to suicidal thoughts. As early in 1932, Dandy found vascular compression of the trigeminal root was the cause of the disorder [1]. Today, this etiology has been widely verified by successful microvascular decompression surgery [2, 3]. However, its underlying pathogenesis has been still unclear up to now. Jannetta had hypothesized the ‘peripheral theory’ which believed that the ephaptic impulses spread at compression sites induced the neuralgia [4]. While, others introduced the ‘central theory’ which believed that the autorhythmicity of trigeminal ganglion (TG) was the main reason [5–7]. Regardless of the peripheral or central theories, there has been few findings concerning the mechanism of trigeminal neuralgia have been reported except the demyelination in the trigeminal root [8–10]. Nevertheless, so far it has been acceptable that the substantiality of the disorder is a sort of hyperexcitability manifested by abnormal discharges or ectopic action potentials [11–13].
Percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia: an alternative technique
Published in British Journal of Neurosurgery, 2018
Menaka Pasangy Paranathala, Leon Ferguson, Richard Bowers, Nitin Mukerji
Trigeminal neuralgia is a debilitating, paroxysmal unilateral facial pain. In cases when medical management has failed, and microvascular decompression is not indicated, there is a role for percutaneous procedures.1 Percutaneous Retrogasserian Glycerol Rhizotomy (PRGR) is one surgical options for management of trigeminal neuralgia (TN). It is minimally invasive, suitable for elderly patients, previously failed Microvascular Decompression (MVD) and patients with Multiple Sclerosis (MS), has a high efficacy rate and long duration of actions.