Trigeminal Neuralgia: Etiology, Diagnosis, and Treatment

Silva, Michael; Ouanounou, Aviv

doi:10.1007/s42399-020-00415-9

Cited by 7 publications

(2 citation statements)

References 47 publications

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“…The main cause for TN is the compression of the 5th cranial nerve, which contains 3 major branches that control the motor functions of the face (37). However, the pathogenesis of TN is not completely clear (38,39). Due to the severe pain, TN often has a catastrophic effect on patients, and seriously affects their quality of life (40).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of microvascular decompression versus percutaneous balloon compression in the treatment of trigeminal neuralgia: a systematic review and meta-analysis

Xiao

Chen

et al. 2022

Ann Palliat Med

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Background: Trigeminal neuralgia (TN) is a type of transient and paroxysmal recurrent severe pain confined to the trigeminal nerve region. This study systematically evaluated the efficacy and safety of microvascular decompression (MVD) and percutaneous balloon compression (PBC) in the treatment of TN.Methods: PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure, Wanfang, and Weipu databases were searched for articles published on the use of MVD and PBC in the treatment of TN from the dates of inception of the databases to October 2019. Articles on MVD and PBC in the treatment of TN were selected, and a meta-analysis was performed using RevMan 5.2 software.Results: Eighteen studies (comprising 1,932 patients) were included in the study. MVD and PBC had similar overall effective rates in treating TN [odds ratio (OR) =0.79, 95% confidence interval (CI): 0.55-1.13, P=0.19]. Patients treated with PBC had a higher recurrence rate of TN than those treated MVD (OR =3.50, 95% CI: 2.25-5.44; P<0.00001), and patients treated with PBC experienced more adverse reactions than those treated with MVD (OR =17.79, 95%

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of microvascular decompression versus percutaneous balloon compression in the treatment of trigeminal neuralgia: a systematic review and meta-analysis

Xiao

Chen

et al. 2022

Ann Palliat Med

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“…Silvia et al [ 8 ], provide excellent insights regarding the treatment of TN and highlight the need for improvement and updates in the management of TN; as an estimated 50% of patients fail to achieve complete pain relief with medico/pharmacological options and ultimately opt for surgical interventions. Meta-analyses have reported that microvascular decompression (MVD) was the most efficacious surgical treatment for classical TN caused by trigeminal nerve compression by a branch of the basilar artery which provides pain relief for 4–5 years in 61 to 80% patients [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of high-voltage pulsed radiofrequency to treat patients with primary trigeminal neuralgia: a multicenter, randomized, double-blind, controlled study

et al. 2023

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Background Trigeminal neuralgia (TN) is a debilitating pain disorder that still lacks an ideal treatment option. Pulsed radiofrequency (PRF), especially with high output voltage, is a novel and minimally invasive technique. PRF is regarded a promising treatment option for TN patients who respond poorly to medical treatment; however, the available evidence still lacks high quality randomized controlled trials (RCTs). Our study aimed to evaluate the long-term (1 year and 2 years) effects and safety of high-voltage PRF in primary TN patients and provide stronger evidence for TN treatment options. Methods We performed a multicenter, double-blind, RCT in adults (aged 18–75 years) with primary TN who responded poorly to drug therapy or were unable to tolerate the side effects of drug. Eligible participants were randomly assigned (1:1) to receive either high voltage PRF or nerve block with steroid and local anesthetic drugs. The primary endpoint was the 1-year response rate. This trial has been registered in the clinicaltrials.gov website (registration number: NCT03131466). Results One hundred and sixty-two patients were screened for enrollment between April 28th,2017 and September1st, 2019, among whom, 28 were excluded. One hundred and thirty-four participants were randomly assigned to either receive high voltage PRF (n = 67) or nerve block (n = 67). The proportion of patients with a positive response at 1-year after the procedure in the PRF group was significantly higher than that in the nerve block group in the intention-to-treat population (73.1% vs. 32.8%, p < 0.001). There was no difference between groups in the incidence of adverse events. Conclusions Our findings support that high voltage PRF could be a preferred interventional choice prior to receiving more invasive surgical treatment or neuro-destructive treatment for TN patients who have poor responses to medical treatment. Trial registration Our study has been registered at ClinicalTrials.gov (trial registration number: NCT03131466).

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Intravenous cannula used for continuous intraoral mandibular nerve block in trigeminal neuralgia

Stringer

Borumandi

2021

BMJ Case Rep

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Trigeminal neuralgia is a chronic pain condition affecting one or more distributions of the trigeminal nerve. Patients with this condition experience short, sharp, shooting pain attacks, which can progress to longer, more frequent durations. The pain is often difficult to control. We report of a man who was admitted with severe neuralgia of the third division of the trigeminal nerve. Talking and any oral intake triggered a severe agonising pain. The latter made the regular oral intake of analgesia challenging. The pain was temporarily controlled with frequent local anaesthesia (LA). Dental core trainees were performing regular inferior alveolar nerve blocks which significantly improved patients’ condition allowing him to communicate and have oral intake. Subsequently, a catheter was placed allowing for a continuous anaesthesia. The connecting tube of the cannula was then used by nursing staff to administer LA providing pain relief without the need of repeated intraoral injections.

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Trigeminal Neuralgia: Etiology, Diagnosis, and Treatment

Cited by 7 publications

References 47 publications

Efficacy and safety of microvascular decompression versus percutaneous balloon compression in the treatment of trigeminal neuralgia: a systematic review and meta-analysis

Efficacy and safety of microvascular decompression versus percutaneous balloon compression in the treatment of trigeminal neuralgia: a systematic review and meta-analysis

Effectiveness and safety of high-voltage pulsed radiofrequency to treat patients with primary trigeminal neuralgia: a multicenter, randomized, double-blind, controlled study

Intravenous cannula used for continuous intraoral mandibular nerve block in trigeminal neuralgia

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