Vascular compression is the cause of trigeminal neuralgia

Jannetta, Peter J.

doi:10.1016/s1058-9139(05)80246-3

Cited by 27 publications

(8 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Como a compressão vascular é a causa mais aceita de NT essencial, a microdescompressão vascular pode ser considerada como o método de tratamento mais racional 11,12 . Com este procedimento o índice de sucesso inicial é de 92,7% 5 , a mortalidade de 0,7% e a recorrência de 2% por ano 13,14 .…”

Section: Discussionunclassified

Rizotomia trigeminal por radiofrequência para tratamento da neuralgia do trigêmeo: resultados e modificação técnica

Gusmão¹,

Magaldi²,

Arantes³

2003

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

RESUMO -O objetivo deste estudo é avaliar a eficácia da rizotomia trigeminal por radiofrequência no tratamento da neuralgia essencial do trigêmeo em 135 pacientes e propor modificação da técnica para guiar a punção do forame oval. Cento e um (74,8%) pacientes foram tratados com apenas um procedimento cirúrgico e os 34 (25,2%) restantes necessitaram dois procedimentos. O tempo de avaliação pós-operatória variou de 6 meses a 15 anos. O alívio das crises de dor no pós-operatório imediato ocorreu em 131 (97,0%) pacientes. Após a realização do primeiro procedimento, houve recorrência em 33 (24,5%) pacientes. As complicações incluíram diminuição do reflexo corneano (4,4%), paresia do masseter (2,2%), disestesia dolorosa (1,5%) e anestesia dolorosa (0,7%). A rizotomia trigeminal por radiofrequência constitui procedimento minimamente invasivo, de baixo risco e com alta eficácia. O uso da fluoroscopia por tomografia computadorizada torna a punção do forame oval mais fácil, rápida e precisa.PALAVRAS-CHAVE: termocoagulação por radiofrequência, rizotomia, nervo trigêmeo, neuralgia do trigêmeo. T T T T Trigeminal radiofrequency rhizotomy for the treatment of trigeminal neuralgia: results and technical modification rigeminal radiofrequency rhizotomy for the treatment of trigeminal neuralgia: results and technical modification rigeminal radiofrequency rhizotomy for the treatment of trigeminal neuralgia: results and technical modification rigeminal radiofrequency rhizotomy for the treatment of trigeminal neuralgia: results and technical modification rigeminal radiofrequency rhizotomy for the treatment of trigeminal neuralgia: results and technical modification ABSTRACT -The purpose of this study was to evaluate the efficacy of radiofrequency trigeminal rhizotomy in treating 135 patients harboring trigeminal neuralgia, and to introduce a technical modification to guide the puncture of the foramen ovale. A hundred and one (74.8%) patients were treated with a single surgical procedure whereas the 34 (25.2%) remaining patients required two procedures. Follow-up ranges from 6 months to 15 years. Pain relief in the immediate postoperative was achieved in 131 (97.0%) patients. After the initial procedure, recurrence happened in 33 (24.5%) patients. The complications included decrease corneal reflex (4.4%), masseter paresis (2.2%), painful dysesthesia (1.5%) and anesthesia dolorosa (0.7%). The radiofrequency trigeminal rizhotomy is a low risk, highly effective and minimally invasive procedure. The use of the computerized tomography guided fluoroscopy turns foramen ovale's puncture easier, fast and precise.KEY WORDS: radiofrequency thermocoagulation, rhizotomy, trigeminal nerve, trigeminal neuralgia. A neuralgia do trigêmeo (NT) é a mais frequente das neuralgias craniofaciais. Caracteriza-se por paroxismos de dor tipo choque, de breve duração e recorrentes, na distribuição somatosensorial de um ou mais ramos do nervo trigêmeo. Ocorre em incidência anual de quatro a cinco pacientes por cem mil pessoas 1 . Sua causa ainda é motivo de disc...

show abstract

Section: Discussionunclassified

Rizotomia trigeminal por radiofrequência para tratamento da neuralgia do trigêmeo: resultados e modificação técnica

Gusmão¹,

Magaldi²,

Arantes³

2003

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…Although the procedure was performed by some neurosurgeons worldwide, it gained evidence and vast acceptance in the medical community when Dr Peter Jannetta improved it by using an operating microscope [ 136 ]. Dr Jannetta performed the first microvascular decompression surgery in 1966, but it took about a decade for the procedure to gain acceptance [ 137 ]. Over time, long-term studies have reported the efficacy and durability of the MVD procedure, with long term success rate, which is estimated at around 70%.…”

Section: Treatmentmentioning

confidence: 99%

Trigeminal Neuralgia: Basic and Clinical Aspects

et al. 2020

View full text Add to dashboard Cite

The trigeminal nerve is the largest of all cranial nerves. It has three branches that provide the main sensory innervation of the anterior two-thirds of the head and face. Trigeminal neuralgia (TN) is characterized by sudden, severe, brief, and stabbing recurrent episodes of facial pain in one or more branches of the trigeminal nerve. Pain attacks can occur spontaneously or can be triggered by non-noxious stimuli, such as talking, eating, washing the face, brushing teeth, shaving, a light touch or even a cool breeze. In addition to pain attacks, a proportion of the patients also experience persistent background pain, which along with autonomic signs and prolonged disease duration, represent predictors of worse treatment outcomes. It is now widely accepted that the presence of a neurovascular compression at the trigeminal root entry zone is an anatomic abnormality with a high correlation with classical TN. However, TN may be related to other etiologies, thus presenting different and/or additional features. Since the 1960s, the anticonvulsant carbamazepine is the drug of choice for TN treatment. Although anti-epileptic drugs are commonly used to treat neuropathic pain in general, the efficacy of carbamazepine has been largely limited to TN. Carbamazepine, however, is associated with dose-limiting side-effects, particularly with prolonged usage. Thus, a better understanding and new treatment options are urgently warranted for this rare, but excruciating disease.

show abstract

“…The tradeoff was loss of the axon function. When Dr. Jannetta performed his MVD procedure on the dorsal root entry zone (DREZ) of the trigeminal nerve, the axons’ structure and function were preserved [ 2 - 5 ].…”

Section: Reviewmentioning

confidence: 99%

“…If the proximity criterion is removed, the tic symptoms are arrested, and in Dr. Jannetta’s MVD procedure, this is accomplished without destroying the function of the axons involved. The necessity of the proximity factor was further demonstrated by Dr. Jannetta’s dramatic stop/restart display during surgery on the facial nerve [ 2 - 5 , 19 ].…”

Section: Reviewmentioning

confidence: 99%

“…Despite significant progress in the neurosurgical management of this entity, the etiology, mechanism, and pathophysiology remain an enigma. When Dr. Peter Jannetta reported his microvascular decompression (MVD) procedure on the neurovascular collision site, the etiology was assumed to be the mechanical compression of the nerve by the artery [ 2 - 5 ]. Suspecting that other mechanisms may be operative, I began a review of my experience and that of my peers, and a study of the applicable literature.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Electromagnetic Induction Aberration: The Possible Mechanism of Tic Douloureux

Rish¹

2015

Cureus

View full text Add to dashboard Cite

A theory based on the principles of electromagnetic induction aberration is presented as the possible mechanism of classic trigeminal neuralgia, tic douloureux.The anatomy of the dorsal root entry zone of the trigeminal nerve at the pons in the proximity of the superior cerebellar artery presents a scenario conducive to the phenomenon of electromagnetic induction. When the action potentials traversing the axons in this zone of the compromised myelin come into juxtaposition with the vascular structure, the criteria for electromagnetic induction are satisfied. The laws of physics governing the phenomenon indicate that a new current, an aberration, would be produced. This could be responsible for the clinical symptoms of tic douloureux.Other clinical situations with similar features could share this mechanism. This proposed theory, a merger of anatomy, neurophysiology, and the physics of electromagnetic induction, extends the established concept of vascular compression as the etiology of tic douloureux.

show abstract

Vascular compression is the cause of trigeminal neuralgia

Cited by 27 publications

References 64 publications

Rizotomia trigeminal por radiofrequência para tratamento da neuralgia do trigêmeo: resultados e modificação técnica

Rizotomia trigeminal por radiofrequência para tratamento da neuralgia do trigêmeo: resultados e modificação técnica

Trigeminal Neuralgia: Basic and Clinical Aspects

Electromagnetic Induction Aberration: The Possible Mechanism of Tic Douloureux

Contact Info

Product

Resources

About