Retinal Surgery–induced Trigeminal Neuralgia

Jacobs-El, Naima; Shaikh, Saad

doi:10.1097/icb.0b013e318263d418

Cited by 3 publications

(5 citation statements)

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“…Only two cases of TN post-ophthalmic surgery [ 2 , 3 ] and one case of TN post-retinal surgery [ 1 ] are reported in the literature. Neuropathic pain related to corneal diseases has also been described in the literature, especially because of a disrupted tear film or direct noxious stimulation of the corneal nerves [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are several causes for pain after eye surgery, of which the most frequent causes are irritation of the ocular surface, high intraocular pressure (IOP), and swelling. TN is a rare cause of postoperative pain and has only been described twice in the international literature: one case of pain after vitrectomy with crystalline lens extraction [ 2 ] and another case of an unspecified surgery type [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Trigeminal neuralgia associated with ophthalmic surgery: a case series

Lucena¹,

Sola²,

Soriano

et al. 2018

J Med Case Reports

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BackgroundTrigeminal neuralgia is a rare cause of postoperative pain after ophthalmic surgery and has only been described twice in the international literature: one case of pain after vitrectomy with a crystalline lens extraction and another case of an unspecified surgery type. We report three cases of ophthalmic surgery-induced trigeminal neuralgia.Case presentationTrigeminal neuralgia was diagnosed in three patients after ophthalmic surgery. Patient 1 was a 63-year-old Caucasian man with an epiretinal membrane and cataract in his left eye. Phacovitrectomy was performed. Patient 2 was a 38-year-old Caucasian man with a perforating wound in his right eye. Primary closure of the cornea with removal of the necrotic iris was performed. Patient 3 was a 52-year-old Caucasian man referred 15 days after suffering blunt trauma to his right eye. Vitrectomy was performed to remove the crystalline lens, which was luxated to the vitreous. On postoperative days, these three patients were admitted to an emergency ward due to sudden, shock-like, one-sided facial pain activated by numerous stimuli. After consultation with specialists from the anesthesia and neurology departments, a diagnosis of trigeminal neuralgia was made. This diagnosis was based on the presence of four of the nine clinical criteria described by the International Headache Society, which were met in these three cases.ConclusionsTrigeminal neuralgia is a rare cause of postoperative ophthalmic pain and is a challenging diagnosis for the ophthalmologist. It is necessary to consider the differential diagnosis of atypical pain after ophthalmic surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trigeminal neuralgia associated with ophthalmic surgery: a case series

Lucena¹,

Sola²,

Soriano

et al. 2018

J Med Case Reports

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“…In addition, the classification of migraines is difficult as they share features with other trigeminal cephalgias. Trauma is a known trigger of such headaches, as is ocular surgery [ 3 - 4 ]. Intravitreal injection is a common ophthalmic procedure.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal Injection-Induced Migraine Headaches

Lerebours¹,

Nguyen²,

Sarup³

et al. 2016

Cureus

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“…(3) Jacobs-El et al described the occurrence of this pathology associated with ophthalmic surgery in a 72-year-old man undergoing cataract surgery, under topical anesthesia. (2) According to the authors, the patient's history of multiple sclerosis may have contributed to the development of TGN, since the demyelination process can lead to abnormal excitation of nociceptive neurons, causing disproportionate pain to stimulus. Thus, despite a rare episode, other studies have already observed the occurrence of this condition in patients undergoing ophthalmic surgery.…”

Section: Neuralgia After Ophthalmic Surgerymentioning

confidence: 99%

“…Trigeminal neuralgia (TGN) is a rare cause of postoperative pain and has been little documented in the international literature. (2) Trigeminal neuralgia is a neuropathic pain that affects the cranial nerve V and is characterized by severe paroxysmal facial pain, of sudden onset, especially in areas where nerve branches are distributed. (3) The pathophysiology of TGN has not been fully understood yet, and its causes are diverse.…”

Section: Introductionmentioning

confidence: 99%

Trigeminal neuralgia after corneal transplantation – a case report

Tabarelli¹,

Lynch²

2021

Revista Brasileira De Oftalmologia

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Description of a patient with Fuchs endothelial dystrophy submitted to a corneal transplant, performed by Descemet membrane endothelial keratoplasty, which evolved with sudden, paroxysmal pain in the frontotemporal region, postoperatively. Due to the ophthalmologic picture of the patient, the attending physician believed in possible rejection of the graft, neglecting the complaint of pain. Even after a successful second transplant, performed due to primary failure, disabling pain persisted and the physician did not manage it. After years of investigation, consulting with several specialists, it was concluded the patient presented trigeminal neuralgia that had not been treated since the surgical procedure. In addition, it led to several psychosocial consequences. Therefore, it is essential to be aware trigeminal neuralgia is a possible outcome of corneal transplantation, and its symptoms should not be neglected by the attending physician, thus contributing to better management for transplanted patients. RESUMODescrição do relato de caso de uma paciente com distrofia endotelial de Fuchs submetida a transplante de córnea, realizado pela técnica DMEK, que evoluiu com quadro de dor súbita, paroxística, em região frontotemporal, no pós-operatório. Devido ao quadro oftalmológico da paciente, o médico assistente acreditava em possível rejeição do enxerto, negligenciando a dor. Mesmo após sucesso do segundo transplante, realizado devido à falência primária, as dores incapacitantes persistiam, e nenhuma conduta, por parte do médico, foi realizada. Após anos de investigação, mediante consultas com diversos especialistas, concluiu-se que a paciente apresentava um quadro de neuralgia do nervo trigêmeo que não tinha sido tratada desde a realização do procedimento cirúrgico. Além disso, apresentava uma série de consequências psicossociais. Portanto, torna-se imprescindível entender que a neuralgia do nervo trigêmeo é um possível desfecho do transplante de córnea, e seus sintomas não devem ser negligenciados por parte do médico assistente, contribuindo para melhores condutas para os pacientes transplantados.

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Retinal Surgery–induced Trigeminal Neuralgia

Abstract: The authors report a case of trigeminal neuralgia developed after vitreoretinal surgery. Clinicians should consider trigeminal neuralgia in the differential diagnosis of atypical pain after retinal surgery.

Cited by 3 publications

References 2 publications

Trigeminal neuralgia associated with ophthalmic surgery: a case series

Trigeminal neuralgia associated with ophthalmic surgery: a case series

Intravitreal Injection-Induced Migraine Headaches

Trigeminal neuralgia after corneal transplantation – a case report

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