Fatal Paranasal Sinusitis Presenting as Trigeminal Neuralgia

Lin, Yen-Wen; Lin, Shinn-Kuang; Weng, I-Hsin

doi:10.1111/j.1526-4610.2006.00316_5.x

Cited by 14 publications

(11 citation statements)

References 9 publications

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“…Chronic inflammation of maxillary sinuses and other ear, nose and throat (ENT) inflammatory disorders can be a direct cause of TN development [40,43]. Consequently, 89.5% of our treated patients suffered from inflammatory diseases in the maxillofacial region or had history of inflammatory disorders of ear, nose and throat region.…”

Section: Methodsmentioning

confidence: 99%

Aetiology and Pathogenesis of Trigeminal Neuralgia: a Comprehensive Review

Sabalys¹,

Juodžbalys²,

Wang

2012

JOMR

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ObjectivesThe aim of present paper was to discuss issues related to trigeminal neuralgia with strong emphasis on the aetiology and pathogenesis of this problem.Material and MethodsAn electronic search of 5 databases (1965 - Oct 2012) and a hand search of peer-reviewed journals for relevant articles were performed. In addition, experience acquired from treating 3263 patients in the Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, were also summarized.ResultsGenerally, aetiological factors can be classified into 3 most popular theories that were based on: 1) Related to other disease, 2) Direct injury to the trigeminal nerve, and 3) Propagates the polyetiologic origin of the disease. In addition, two pathogenesis mechanisms of trigeminal neuralgia were proposed. First: the peripheral pathogenetic mechanism that is often induced by progressive dystrophy around the peripheral branches of the trigeminal nerve. Second, central pathogenetic mechanism which often triggered by peripheral pathogen that causes long-lasting afferent impulsation and the formation of a stable pathologic paroxysmal type irritation focus on the central nerve system (CNS).ConclusionsPatients with susceptive trigeminal neuralgia should be examined carefully by specialists who have expertise in assessing and diagnosing of possible pathological processes and be able to eliminate the contributing factors so the trigeminal neuralgia can be properly managed.

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Section: Methodsmentioning

confidence: 99%

Aetiology and Pathogenesis of Trigeminal Neuralgia: a Comprehensive Review

Sabalys¹,

Juodžbalys²,

Wang

2012

JOMR

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“…MS, diabetes mellitus, odontogenic inflammatory diseases, and otolaryngological pathology, such as sinusitis, have also been proposed as causes of TN 22–31…”

Section: Advances In Diagnosismentioning

confidence: 99%

Advances in diagnosis and treatment of trigeminal neuralgia

Montano¹,

Conforti²,

Bonaventura³

et al. 2015

TCRM

148

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Various drugs and surgical procedures have been utilized for the treatment of trigeminal neuralgia (TN). Despite numerous available approaches, the results are not completely satisfying. The need for more contemporaneous drugs to control the pain attacks is a common experience. Moreover, a number of patients become drug resistant, needing a surgical procedure to treat the neuralgia. Nonetheless, pain recurrence after one or more surgical operations is also frequently seen. These facts reflect the lack of the precise understanding of the TN pathogenesis. Classically, it has been related to a neurovascular compression at the trigeminal nerve root entry-zone in the prepontine cistern. However, it has been evidenced that in the pain onset and recurrence, various neurophysiological mechanisms other than the neurovascular conflict are involved. Recently, the introduction of new magnetic resonance techniques, such as voxel-based morphometry, diffusion tensor imaging, three-dimensional time-of-flight magnetic resonance angiography, and fluid attenuated inversion recovery sequences, has provided new insight about the TN pathogenesis. Some of these new sequences have also been used to better preoperatively evidence the neurovascular conflict in the surgical planning of microvascular decompression. Moreover, the endoscopy (during microvascular decompression) and the intraoperative computed tomography with integrated neuronavigation (during percutaneous procedures) have been recently introduced in the challenging cases. In the last few years, efforts have been made in order to better define the optimal target when performing the gamma knife radiosurgery. Moreover, some authors have also evidenced that neurostimulation might represent an opportunity in TN refractory to other surgical treatments. The aim of this work was to review the recent literature about the pathogenesis, diagnosis, and medical and surgical treatments, and discuss the significant advances in all these fields.

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“…2 Interestingly, the patient had trigeminal neuralgia-like symptoms, and paranasal sinusitis can create an unusual trigeminal neuralgia presentation. 10,11 Thus, an inflammatory process inside the left cavernous sinus, irritating the first and second divisions of the trigeminal nerve, might explain the subacute course of her symptoms. 10,11 One of the most remarkable aspects of this case demonstrates the speed with which invasive mycotic fungal aneurysms can progress.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Thus, an inflammatory process inside the left cavernous sinus, irritating the first and second divisions of the trigeminal nerve, might explain the subacute course of her symptoms. 10,11 One of the most remarkable aspects of this case demonstrates the speed with which invasive mycotic fungal aneurysms can progress. The patient's initial angiogram showing the small PCOM artery aneurysm/infundibulum (►Fig.…”

Section: Discussionmentioning

confidence: 99%

Rapidly Fatal Internal Carotid Artery Mycotic Aneurysm Rupture in a Rheumatoid Patient Taking a TNF-α Inhibitor: Case Report and Literature Review

Bowers

Saad

Clegg

et al. 2014

J Neurol Surg A Cent Eur Neurosurg

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Although fungal mycotic aneurysms of the ICA are rare, their incidence may increase with the expanded use of immunosuppressive medications. Patients with rheumatoid arthritis who take potent immunosuppression regimens may be prime candidates for mycotic aneurysms because they often have two favoring conditions: atherosclerosis and immunosuppression. These ICA aneurysms carry a high mortality rate, so early diagnosis and aggressive therapy, potentially by endovascular trapping/vessel occlusion coupled with long-term antifungal therapy, is essential.

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Fatal Paranasal Sinusitis Presenting as Trigeminal Neuralgia

Cited by 14 publications

References 9 publications

Aetiology and Pathogenesis of Trigeminal Neuralgia: a Comprehensive Review

Aetiology and Pathogenesis of Trigeminal Neuralgia: a Comprehensive Review

Advances in diagnosis and treatment of trigeminal neuralgia

Rapidly Fatal Internal Carotid Artery Mycotic Aneurysm Rupture in a Rheumatoid Patient Taking a TNF-α Inhibitor: Case Report and Literature Review

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