Imaging of Trigeminal Neuralgia and Other Facial Pain

Boeddinghaus, Rudolf; Whyte, Andy

doi:10.1016/j.nic.2021.05.008

Cited by 3 publications

(2 citation statements)

References 33 publications

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“…This area is thought to be more vulnerable to damage by the compression since this is the transition zone between the peripherally myelinated nerve root (by Schwann cells) and the centrally myelinated nerve (by oligodendrocytes), i.e., the junction of the peripheral trigeminal nerve and root [14,15]. The demyelination could in most cases be due to a physical external compression by an artery or a vein (most common) or any space-occupying lesion like a vestibular schwannoma, meningioma, or an aneurysm, or a cyst [16,17,18]. The compression is thought to cause ischemic damage to the nerve root, which leads to demyelination.…”

Section: Pathophysiology Molecular Processmentioning

confidence: 99%

Molecular Process Of Trigeminal Neuralgia, its Pharmacologic, and Comparison of Surgical Treatment Options with Outcomes

Shah,

Ikram,

Khan

2024

Preprint

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According to published descriptions, one of the most incapacitating forms of orofacial pain is trigeminal neuralgia (TN). At its core, trigeminal neuropathic pain (TN) is still a clinical diagnostic that has to be differentiated from other forms of TN and face pain linked to other neuralgias or headache disorders. Imaging can only help with the cause of the pain, whether it’s a vascular origin or not. It is becoming more and more evident that there is no one-size-fits-all medication or surgical procedure that can effectively treat every patient with trigeminal neuralgia (TN). This is probably because TN is a diverse collection of conditions that all present with face discomfort. Medical therapy using anticonvulsants like carbamazepine is still the first-line treatment for TN. If this doesn't work for the patient, surgical treatments are available. Microvascular decompression is often a safe, efficient operation with results that are both rapid and long-lasting. Patients who may benefit from percutaneous techniques such as radiofrequency ablation, glycerol ablation, balloon compression, or a combination, include those who cannot undergo general anesthesia or whose medical conditions prohibit a suboccipital craniectomy. Radiosurgery may be a great option for patients with bleeding diathesis brought on by blood-thinning medications who are not eligible for invasive procedures or who do not want to undergo open surgical procedures, as long as the patient is aware that achieving maximum pain relief may take several months. In conclusion, peripheral neurectomies persist in offering a low-cost and resource-saving substitute for pain management to those residing in areas with restricted financial and healthcare resources. In the end, developing a better understanding of the molecular processes behind trigeminal neuralgia will lead to new, less intrusive, and more effective treatments.

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Section: Pathophysiology Molecular Processmentioning

confidence: 99%

Molecular Process Of Trigeminal Neuralgia, its Pharmacologic, and Comparison of Surgical Treatment Options with Outcomes

Shah,

Ikram,

Khan

2024

Preprint

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“…MRI may demonstrate gadolinium-enhancement of the trigeminal nerve or ganglion due to ganglionitis, and a hyperintense lesion on T2-weighted imaging along the trigeminal nuclei and intra-axial portion, including its entry zone, in patients with postherpetic neuralgia 3 . The spinal trigeminal nucleus extends from the inferior pons to the medulla and cervical spinal cord and receives sensory information regarding facial pain and temperature 4 . Thus, its involvement in VZV reactivation may explain the symptoms of postherpetic neuralgia.…”

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confidence: 99%