Microsurgical Pontine Descending Tractotomy in Cases of Intractable Trigeminal Neuralgia

Ibrahim, Tarik F.; Garst, Jonathan; Burkett, Daniel; Toia, Giuseppe V.; Braca, John A.; Hill, Jacquelyn P.; Anderson, Douglas E.

doi:10.1227/neu.0000000000000926

Cited by 13 publications

(10 citation statements)

References 48 publications

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“…Pontine trigeminal tractotomy was used as adjuvant method in a series of 50 patients with typical trigeminal neuralgia refractory to conservative treatment, where neuroimaging investigations have not shown evident vascular conflict, and the same findings were observed in intraoperative retrosygmoid exploration. Just one patient (2%) has not improved, while 18% have reported partial improvement and 80% total pain remission 21 . Trigeminal neuralgia and multiple sclerosis patients have reported 87.5% of good results 21 .…”

Section: Pontine Trigeminal Nucleotractotomymentioning

confidence: 99%

“…Just one patient (2%) has not improved, while 18% have reported partial improvement and 80% total pain remission 21 . Trigeminal neuralgia and multiple sclerosis patients have reported 87.5% of good results 21 .…”

Section: Pontine Trigeminal Nucleotractotomymentioning

confidence: 99%

“…It improves pain in approxi-mately 60% of patients with atypical facial pain 18,[20][21][22] . Trigeminal nerve spinal tract nucleotractotomy and stereotactic pontine trigeminal nucleotractotomy are effective to treat deafferentation facial pain (Wallemberg syndrome, trigeminal neuropathy pain).…”

Section: Pontine Trigeminal Nucleotractotomymentioning

confidence: 99%

“…Motor cortex stimulation (MCS) is considered promising, especially to treat trigeminal NP and post-stroke central pain syndromes, such as thalamic pain and brachial plexus avulsion, among others 21,[61][62][63] . Most studies involving MCS focuses on post-stroke and atypical trigeminal neuropathy, for which there are few effective treatments.…”

Section: Motor Cortex Electrical Stimulationmentioning

confidence: 99%

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Invasive treatment to control neuropathic pain

Júnior¹,

Correa

Ferreira

2016

Revista Dor

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BACKGROUND AND OBJECTIVES: Distress, allied to neuropathic pain persistence and its refractory nature, often leads patients to accept invasive procedures. Neuropathic pain control is a major medical challenge requiring approaches and decisions especially based on effectiveness, risks and costs. This study aimed at reviewing these aspects related to major invasive procedures. CONTENTS: Major invasive procedures to control neuropathic pain are presented. Initially, classically reversible anesthetic blocks; then invasive neuromodulation techniques using electric current application and the magnetic field generated by it becomes a target to be stimulated, inhibited or modified in the nervous system (central, peripheral or autonomic); and, finally, ablative procedures including anesthetic methods administering neurolytic agents rather than anesthetics and neurosurgeries using different methods to injure the nervous system to control painful neuropathic discomfort. CONCLUSION: Patients eligible to invasive procedures to control neuropathic pain have, in addition to pain itself, a mixed distress including the collection of repeated delusions at every treatment failure. They have reserved prognosis with regard to total cure and, unfortunately, relieve obtained with invasive treatment in general does not reach persistent and high rates. In such adverse situation, these partial results of decreasing original pain intensity may be interpreted as acceptable, provided the impact on final quality of life is positive. Maybe, the rare exceptions are good results obtained with typical idiopathic/cryptogenic neuralgias ironically excluded from the stricter interpretation of the new pathophysiologic classification of neuropathic pains. Keywords: Anesthetic blocks, Cordectomy, Cortical electrical stimulation, Deep electrical brain stimulation, DREZotomy, Invasive neuromodulation, Medullary electrical stimulation, Neurolytic blocks, Neuropathic pain, Neurosurgery for neuropathic pain, Spinal drugs RESUMO JUSTFICATIVA E OBJETIVOS: O sofrimento aliado à persistência e refratariedade da dor neuropática frequentemente leva seu portador a aceitar tratamentos invasivos. O controle da dor neuropática representa um desafio médico importante necessitando adoção de condutas e decisões baseadas, principalmente, em efetividade, riscos e custos. O escopo deste estudo foi a revisão desses aspectos relacionados aos principais procedimentos invasivos CONTEÚDO: São apresentados os principais procedimentos invasivos utilizados para o controle da dor neuropática. Inicialmente, os bloqueios anestésicos, classicamente reversíveis; depois as técnicas de neuromodulação invasiva que utilizam a aplicação de corrente elétrica e o campo magnético por ela gerado em alvos a serem estimulados, inibidos ou modificados, no sistema nervoso (central, periférico ou autônomo); e, finalmente, os procedimentos ablativos que incluem os métodos anestésicos que administram agentes neurolíticos ao invés de anestésicos, e, as neurocirurgias que utilizam métodos dive...

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Section: Pontine Trigeminal Nucleotractotomymentioning

confidence: 99%

Section: Pontine Trigeminal Nucleotractotomymentioning

confidence: 99%

Section: Pontine Trigeminal Nucleotractotomymentioning

confidence: 99%

Section: Motor Cortex Electrical Stimulationmentioning

confidence: 99%

See 2 more Smart Citations

Invasive treatment to control neuropathic pain

Júnior¹,

Correa

Ferreira

2016

Revista Dor

View full text Add to dashboard Cite

show abstract

“…The objective of this study was to develop a standardized protocol using commercially‐available deterministic tractography software to visualize the descending tract of cranial nerve V and its characteristic “elbow” for preoperative neurosurgical planning. Subsequently, we believe that intraoperative integration with commercial stereotactic neuronavigational software would improve the accuracy of procedures aimed at altering or lesioning the SpTV within the brainstem …”

Section: Introductionmentioning

confidence: 99%