Academic literature on the topic 'Trigeminal complex'
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Journal articles on the topic "Trigeminal complex"
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Brown, Jeffrey A. "The Trigeminal Complex." Neurosurgery Clinics of North America 8, no. 1 (January 1997): 1–10. http://dx.doi.org/10.1016/s1042-3680(18)30333-4.
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Mehnert, Jan, Hauke Basedau, Lisa-Marie Sturm, Trine Nielsen, Rigmor Højland Jensen, and Arne May. "Functional brainstem representations of the human trigeminal cervical complex." Cephalalgia 43, no. 5 (May 2023): 033310242311748. http://dx.doi.org/10.1177/03331024231174862.
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Background The human in-vivo functional somatotopy of the three branches of the trigeminal (V1, V2, V3) and greater occipital nerve in brainstem and also in thalamus and insula is still not well understood. Methods After preregistration (clinicaltrials.gov: NCT03999060), we mapped the functional representations of this trigemino-cervical complex non-invasively in 87 humans using high-resolution protocols for functional magnetic resonance imaging during painful electrical stimulation in two separate experiments. The imaging protocol and analysis was optimized for the lower brainstem and upper spinal cord, to identify activation of the spinal trigeminal nuclei. The stimulation protocol involved four electrodes which were positioned on the left side according to the three branches of the trigeminal nerve and the greater occipital nerve. The stimulation site was randomized and each site was repeated 10 times per session. The participants partook in three sessions resulting in 30 trials per stimulation site. Results We show a large overlap of peripheral dermatomes on brainstem representations and a somatotopic arrangement of the three branches of the trigeminal nerve along the perioral-periauricular axis and for the greater occipital nerve in brainstem below pons, as well as in thalamus, insula and cerebellum. The co-localization of greater occipital nerve with V1 along the lower part of brainstem is of particular interest since some headache patients profit from an anesthetic block of the greater occipital nerve. Conclusion Our data provide anatomical evidence for a functional inter-inhibitory network between the trigeminal branches and greater occipital nerve in healthy humans as postulated in animal work. We further show that functional trigeminal representations intermingle perioral and periauricular facial dermatomes with individual branches of the trigeminal nerve in an onion shaped manner and overlap in a typical within-body-part somatotopic arrangement. Trial registration: clinicaltrials.gov: NCT03999060
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BALYAZINA, E. V., T. A. ISAKHANOVA, and N. A. ALEKSEEVA. "CLASSICAL TRIGEMINAL NEURALGIA COMPLEX THERAPY." Kubanskij nauchnyj medicinskij vestnik 1, no. 2 (January 1, 2017): 21–24. http://dx.doi.org/10.25207/1608-6228-2017-2-21-24.
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Clement, M. E., and R. B. McCall. "Characterization of midline medulla role in the trigeminal depressor response." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 256, no. 5 (May 1, 1989): R1111—R1120. http://dx.doi.org/10.1152/ajpregu.1989.256.5.r1111.
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The purpose of the present investigation was to determine the role of the midline medulla in mediating the trigeminal depressor response. Previously we found that lesions of the midline medulla abolished the decrease in blood pressure resulting from electrical stimulation of the spinal trigeminal complex. Electrical stimulation (5 Hz) of the spinal trigeminal tract elicited a decrease in arterial blood pressure that was associated with an inhibition of sympathetic nerve activity recorded from the inferior cardiac nerve of anesthetized cats. The effect of single shocks applied to the trigeminal complex on sympathetic activity was determined using computer-averaging techniques. Single shock stimulation consistently elicited an excitation of sympathetic activity that was followed by an inhibition of sympathetic nerve discharge. The gamma-aminobutyric acid antagonist picrotoxin blocked the depressor response elicited by electrical stimulation of the midline medulla but not by stimulation of the spinal trigeminal complex. Extracellular recordings of the discharges of midline medullary neurons were made to determine the effects of trigeminal stimulation on sympathoinhibitory, sympathoexcitatory, and serotonin neurons. Sympathoinhibitory and sympathoexcitatory neurons were identified by the relationship between unitary discharges and sympathetic nerve activity and by their response to baroreceptor reflex activation. Serotonin (5-HT) neurons were identified using criteria previously developed in our laboratory. These included 1) a slow regular discharge rate, 2) sensitivity to the inhibitory action of the 5-HT1A agonist 8-OH 8-hydroxy-2-(di-n-propylamino)tetralin, 3) failure to respond to baroreceptor reflex activation, and 4) the discharges of the 5-HT neurons were not related to sympathetic activity. Stimulation of the spinal trigeminal complex typically inhibited the discharges of sympathoinhibitory neurons. In contrast, stimulation of the trigeminal complex consistently excited both sympathoexcitatory and 5-HT neurons. These results are discussed in relationship to the role of the midline medulla in mediating the trigeminal depressor response.
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Chávez, Gabriela-del-Rocío Chávez, Antonio A. F. De Salles, Timothy D. Solberg, Alessandra Pedroso, Dulce Espinoza, and Pablo Villablanca. "Three-dimensional Fast Imaging Employing Steady-state Acquisition Magnetic Resonance Imaging for Stereotactic Radiosurgery of Trigeminal Neuralgia." Neurosurgery 56, no. 3 (March 1, 2005): E628. http://dx.doi.org/10.1227/01.neu.0000154709.44776.50.
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Abstract OBJECTIVE: The aim of this study was to demonstrate the use and applications of the three-dimensional fast imaging employing steady-state acquisition (3-D-FIESTA) magnetic resonance imaging sequence in targeting and planning for stereotactic radiosurgery of trigeminal neuralgia. METHODS: A 3-D-FIESTA sequence for visualization of cranial nerves in the cranial base was added to the routine magnetic resonance imaging scan to enhance the treatment planning for trigeminal neuralgia. T1-weighted images, 1 mm thick, were directly compared with the FIESTA sequence for the exact visualization of the trigeminal entry zone and surrounding vasculature. The target accuracy was evaluated by image fusion of computed tomographic and magnetic resonance imaging scans. The anatomy visualized with the FIESTA sequence was validated by direct inspection of the gross anatomic specimens of the trigeminal complex. RESULTS: A total of 15 consecutive patients, 10 women and 5 men, underwent radiosurgery for essential trigeminal neuralgia between April and July, 2003. The mean age of the patients was 65.2 years (range, 24–83 yr). Nine patients had right-sided symptoms. Four patients had had previous surgery (two microvascular decompression, one percutaneous rhizotomy, and one radiofrequency thermocoagulation). The 3-D-FIESTA sequence successfully demonstrated the trigeminal complex (root entry zone, trigeminal ganglion, rootlets, and vasculature) in 14 patients (93.33%). The 3-D-FIESTA sequence also allowed visualization of the branches of the trigeminal nerve inside Meckel's cavity. This exact visualization correlated precisely with the anatomic specimens. In one patient (6.66%), it was not possible to demonstrate the related vasculature. However, the other structures were clearly visualized. CONCLUSION: The 3-D-FIESTA sequence is used in this study for demonstration of the exact anatomy of the trigeminal complex for the purpose of radiosurgical planning and treatment of trigeminal neuralgia. With such imaging techniques, radiosurgical targeting of specific trigeminal nerve branches may be feasible. It has not been possible previously to target individual branches of the trigeminal nerve.
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Visconti, Ciro, Leone Leone, Michele Mario Zarrelli, and Alfredo Del Gaudio. "Cervical Spinal Dorsal Root Stimulation in Trigeminal Neuralgia." Pain Medicine Case Reports 5, no. 8 (November 30, 2021): 379–83. http://dx.doi.org/10.36076/pmcr.2021.5.8.
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BACKGROUND: The treatment of trigeminal neuralgia is a challenge especially for cases refractory to the common standard of care. Neurostimulation for pain relief has been used over the years with different targets and modalities. Few reports exist about the stimulation of high cervical spinal dorsal roots to treat trigeminal pain. CASE REPORT: We report a case of a refractory secondary trigeminal neuralgia that was progressively resistant to various treatments. A trial for upper cervical spinal dorsal root stimulation provided immediate good facial pain relief, evoking paresthesias only in the cervical dermatomes. Positive results were obtained over 3 years with reduction of pain, drugs, and improvement in quality of life. DISCUSSION: Neurostimulation of the high cervical spinal dorsal roots with the activation of the trigeminocervical complex may be an effective and safe treatment for refractory trigeminal neuralgia. KEY WORDS: Spinal dorsal root neurostimulation, trigeminal neuralgia, trigeminocervical complex
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Gaydhanker, Anuradha Prasanna, and Prasanna Shravan Gaydhanker. "A study on trigeminal nerve: Does superior cerebellar artery causes trigeminal neuralgia." Indian Journal of Clinical Anatomy and Physiology 9, no. 3 (October 15, 2022): 174–78. http://dx.doi.org/10.18231/j.ijcap.2022.037.
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Our brain is the most complex organ in our body which conducts various complex functions and this level of complexity is operated by different structures of the brain. The complexity of relaying information between brain and different parts of the body is conducted by 12 pairs of cranial nerves. Out of 12 pairs of cranial nerves, the most complex and largest nerve is know as trigeminal nerve which is responsible for sensation of face and motor functions such as biting and chewing. Sometimes due to offendation of this nerve typically by Superior Cerebellar Artery leads to most excruciating painful disorder humanity have ever witnessed.: A systemic self-study was planned to determine and review with proper enlightenment on the existing facts to find the root sources of trigeminal neuralgia.This article discussed and focused on the exact cause of trigeminal neuralgia it’s association with Superior Cerebellar Artery along with descriptive analysis on the available treatments for this disorder. We concluded with the fact that based on our thorough review and analysis Superior Cerebellar Artery is the main artery which typically causes world’s most excruciating painful Suicide Disease.
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Igawa, Kaori, Hideki Funahashi, Yu Miyahara, Rumi Naono-Nakayama, Hisae Matsuo, Yoshihiro Yamashita, Sumio Sakoda, Toshikazu Nishimori, and Yasushi Ishida. "Distribution of hemokinin-1 in the rat trigeminal ganglion and trigeminal sensory nuclear complex." Archives of Oral Biology 79 (July 2017): 62–69. http://dx.doi.org/10.1016/j.archoralbio.2017.03.004.
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Jones, Lauren M., SooHyun Lee, Jason C. Trageser, Daniel J. Simons, and Asaf Keller. "Precise Temporal Responses in Whisker Trigeminal Neurons." Journal of Neurophysiology 92, no. 1 (July 2004): 665–68. http://dx.doi.org/10.1152/jn.00031.2004.
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The ability of rats using their whiskers to perform fine tactile discrimination rivals that of humans using their fingertips. Rats must perform these discriminations rapidly and accurately while palpating the environment with their whiskers. This suggests that whisker-derived inputs produce a robust and reliable code, capable of capturing complex, high-frequency information. The first neural representation of whisker-derived stimulus information is in primary afferent neurons of the trigeminal ganglion. Here we demonstrate that there is a continuum of direction-dependent response profiles in trigeminal neurons and provide the first quantitative analysis of the encoding of complex stimuli by these neurons. We show that all classes of trigeminal ganglion neurons respond with highly reproducible temporal spike patterns to transient stimuli. Such a robust coding mechanism may allow rapid perception of complex tactile features.
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Rigoard, Philippe, Maxime Billot, Maarten Moens, Lisa Goudman, Hassan El-Hajj, Pierre Ingrand, Amine Ounajim, et al. "Evaluation of External Trigeminal Nerve Stimulation to Prevent Cerebral Vasospasm after Subarachnoid Hemorrhage Due to Aneurysmal Rupture: A Randomized, Double-Blind Proof-of-Concept Pilot Trial (TRIVASOSTIM Study)." International Journal of Environmental Research and Public Health 20, no. 10 (May 16, 2023): 5836. http://dx.doi.org/10.3390/ijerph20105836.
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Cerebral vasospasm remains the most frequent and devastating complication after subarachnoid aneurysmal hemorrhage because of secondary cerebral ischemia and its sequelae. The underlying pathophysiology involves vasodilator peptide release (such as CGRP) and nitric oxide depletion at the level of the precapillary sphincters of the cerebral (internal carotid artery network) and dural (external carotid artery network) arteries, which are both innervated by craniofacial autonomic afferents and tightly connected to the trigeminal nerve and trigemino-cervical nucleus complex. We hypothesized that trigeminal nerve modulation could influence the cerebral flow of this vascular network through a sympatholytic effect and decrease the occurrence of vasospasm and its consequences. We conducted a prospective double-blind, randomized controlled pilot trial to compare the effect of 10 days of transcutaneous electrical trigeminal nerve stimulation vs. sham stimulation on cerebral infarction occurrence at 3 months. Sixty patients treated for aneurysmal SAH (World Federation of Neurosurgical Societies scale between 1 and 4) were included. We compared the radiological incidence of delayed cerebral ischemia (DCI) on magnetic resonance imaging (MRI) at 3 months in moderate and severe vasospasm patients receiving trigeminal nerve stimulation (TNS group) vs. sham stimulation (sham group). Our primary endpoint (the infarction rate at the 3-month follow-up) did not significantly differ between the two groups (p = 0.99). Vasospasm-related infarctions were present in seven patients (23%) in the TNS group and eight patients (27%) in the sham group. Ultimately, we were not able to show that TNS can decrease the rate of cerebral infarction secondary to vasospasm occurrence. As a result, it would be premature to promote trigeminal system neurostimulation in this context. This concept should be the subject of further research.
Dissertations / Theses on the topic "Trigeminal complex"
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Barnet, Maxime. "Etude comparative chez les rats mâles et femelles de l'implication du complexe trigémino-cervical et du locus coeruleus dans l'intégration d'une douleur méningée." Electronic Thesis or Diss., Université Clermont Auvergne (2021-...), 2021. http://www.theses.fr/2021UCFAC120.
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La migraine est une pathologie chronique qui est caractérisée par la survenue d’intenses céphalées associées à d’autres symptômes tels que la photo/phonophobie, nausée/vomissements ou encore allodynie : douleur déclenchée par une stimulation non douloureuse. Ces symptômes apparaissent par crises entrecoupées d’intervalles d’accalmie. La migraine touche 15 à 18% de la population dans le monde, est retrouvée préférentiellement chez les femmes, et parfois de manière plus intense lors des menstruations. Même si certains mécanismes de la migraine commencent à être connus, il reste de nombreuses questions et notamment de savoir comment se fait l’intégration de la douleur migraineuse et si cette intégration est différente selon le sexe des individus.Dans notre projet, nous avons exploré chez les rats mâles et femelles, l’implication du complexe trigémino-cervical (CTC) et du Locus Coeruleus (LC) dans le développement de l’allodynie cutanée dans un modèle de douleur méningée induit par l’injection répétée de soupe inflammatoire (IS). La première région cérébrale, le CTC, constitue le premier relai central provenant de la région orofaciale dont les méninges. Le LC est un noyau noradrénergique dont les voies descendantes vont, entre autres, moduler la douleur et projeter sur le CTC. En combinant des analyses comportementales et des techniques immunohistologiques, nous avons montré chez les mâles comme chez les femelles qu’une injection durale d’IS induit une allodynie, qui devient persistante lors de la répétition des injections d’IS. Cependant, l’évolution de l’allodynie est plus rapide chez les femelles. En dissociant les femelles selon leur cycle hormonal : proestrus/estrus (P/E) et Metestrus/Diestrus (M/D), nous avons montré que les femelles P/E avaient une allodynie céphalique plus importante que les femelles M/D après 2 injections d’IS. De plus, en utilisant le marqueur d’activation neuronal c-Fos, les femelles aux stades P/E présentaient une activation plus importante dans le CTC suite à l’inflammation des méninges. Contrairement aux neurones du CTC, les neurones du LC n’ont pas été activés par l’IS, cependant, nous avons pu observer, en condition physiologique, un dimorphisme sexuel importants du LC : les neurones C-Fos dans le LC sont en quantité plus importante chez la femelle que chez le mâle. Enfin, nous nous sommes intéressés aux projections du LC à l’aide de techniques de traçage, et confirmé l’existence de projections directes du LC sur le CTC et de projections indirectes, utilisant la médulla rostro-ventrale comme intermédiaire. Nous avons également observé l’existence de projections corticales superficielles, qui pourraient avoir une influence sur la vascularisation méningée, et indirectement sur le CTC. Il n’existe cependant pas de différences anatomiques de ces projections entre les mâles et les femelles.L’ensemble de ces résultats démontre que l’intégration d’une douleur méningée dépend du cycle hormonal, et que l’activité du CTC est le reflet de cette intégration après deux injections d’IS. Nous avons également montré l’existence de voies directes et indirectes pouvant permettre au LC de moduler le CTC. Enfin, notre projet démontre la nécessité d’inclure les deux sexes dans les études scientifiques et de prendre en compte le cycle hormonalMigraine is a chronic condition characterised by the occurrence of intense headaches associated with other symptoms such as photo/phonophobia, nausea/vomiting or allodynia: pain triggered by non-painful stimulation. These symptoms appear in attacks interspersed with intervals of calm. Migraines affect 15 to 18% of the population worldwide, and are found preferentially in women, sometimes more intensely during menstruation. Although some of the mechanisms of migraine are beginning to be understood, there are still many questions to be answered, in particular how migraine pain is integrated and whether this integration differs according to the sex of the individual.In our project, we explored in male and female rats the involvement of the trigemino-cervical complex (TCC) and the Locus Coeruleus (LC) in the development of skin allodynia in a model of meningeal pain induced by repeated injection of inflammatory soup (IS). The first brain region, the TCC, is the first central relay from the orofacial region including the meninges. The LC is a noradrenergic nucleus whose descending pathways will, among other things, modulate pain and project to the TCC. By combining behavioural analyses and immunohistological techniques, we have shown in both males and females that a dural injection of IS induces allodynia, which becomes persistent with repeated IS injections. However, the evolution of allodynia is more rapid in females. By dissociating females according to their hormonal cycle: proestrus/estrus (P/E) and Metestrus/Diestrus (M/D), we showed that P/E females had a greater cephalic allodynia than M/D females after 2 injections of IS. Furthermore, using the neuronal activation marker c-Fos, P/E females showed greater activation in the TCC following meningeal inflammation. In contrast to TCC neurons, LC neurons were not activated by IS, however, we could observe, under physiological conditions, a significant sexual dimorphism of the LC: C-Fos neurons in the LC are in greater quantity in females than in males. Finally, we examined the projections of the LC using tracing techniques and confirmed the existence of direct projections of the LC to the TCC and indirect projections using the rostro-ventral medulla as an intermediate. We also observed the existence of superficial cortical projections, which could have an influence on the meningeal vasculature, and indirectly on the TCC. However, there are no anatomical differences in these projections between males and females.Taken together, these results demonstrate that the integration of meningeal pain is dependent on the hormonal cycle, and that TCC activity reflects this integration after two injections of SI. We have also shown the existence of direct and indirect pathways that may allow the LC to modulate the TCC. Finally, our project demonstrates the need to include both sexes in scientific studies and to take into account the hormonal cycle
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Dauvergne, Céline. "Etude anatomique des circuits neuronaux intervenant dans le réflexe de clignement chez le rat." Paris 6, 2004. http://www.theses.fr/2004PA066076.
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Ndiaye, Awa. "Colliculus superieur et mouvement des paupières : mise en evidence de voies colliculo-faciale et colliculo-trigemino-faciale intervenant dans le réflexe de clignement chez le rat." Paris 6, 2004. http://www.theses.fr/2004PA066245.
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Ervolino, Edilson. "Inervação autonômica da articulação temporomandibular em condições de normalidade e, padrão de ativação neuronal no tronco encefálico durante a vigência de artrite no complexo articular temporomandibular." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/42/42134/tde-01102009-162540/.
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Os objetivos do presente trabalho foram: 1) analisar a distribuição das fibras nervosas autonômicas na articulação temporomandibular (ATM) do rato, através da detecção de tirosina hidroxilase (TH), neuropeptídeo Y (NPY) e peptídeo intestinal vasoativo (VIP); 2) realizar um estudo topográfico ultra-estrutural das fibras e terminações nervosas autonômicas na ATM do rato; 3) determinar o padrão de ativação neuronal no complexo nuclear trigeminal e, em centros nervosos moduladores da dor, durante a vigência de monoartrite no complexo articular temporomandibular (CATM) do rato. Para o primeiro propósito o método imunoistoquímico, para a detecção simultânea de TH, NPY e VIP, foi executado em ATMs que apresentavam as seguintes condições: inervação intacta ou desprovida de inervação simpática e/ou parassimpática. Para o segundo propósito aliamos o tratamento prévio com 5-hidroxidopamina, para evidenciação de terminações nervosas simpáticas, com a remoção cirúrgica do gânglio ótico, para a visualização das fibras e terminações nervosas parassimpáticas em degeneração, em seguida analisamos as ATMs ao microscópio eletrônico de transmissão. O terceiro propósito foi obtido induzindo-se monoartrite (fase aguda, crônica e crônica ativa) no CATM e, verificando a expressão de Fos, um marcador de ativação neuronal, no complexo nuclear sensorial trigeminal e nos principais centros nervosos moduladores da dor, situados no tronco encefálico (substância cinzenta periaqueductal- PAG; área rostral ventromedial da medula oblonga- RVM; locus coeruleus- LC; área caudal ventrolateral da medula oblonga- CVLM; núcleo do trato solitário- NTS e; núcleo reticular ventral-NRV). Verificamos que as ATMs desprovidas de inervação simpática apresentam exclusivamente uma pequena quantidade de fibras nervosas VIP-IR, ao passo que aquelas desprovidas de inervação parassimpática mostram uma grande quantidade de fibras nervosas TH/NPY-IR e TH/NPY/VIP-IR. As fibras e terminações nervosas autonômicas foram observadas em vasos sanguíneos ou isoladas no tecido conjuntivo, especialmente na membrana sinovial. No que se refere à expressão de Fos, constatamos que o subnúcleo caudal do núcleo do tracto espinal do nervo trigêmeo (Sp5C) e a PAG apresentaram um aumento bilateral significante na expressão de Fos durante todas as fases da monoartrite induzida no CATM. Todavia, RVM, LC, CVLM, NTS apresentaram uma quantidade de neurônios Fos-IR significativamente aumentada, de ambos os lados, apenas quando o CATM estava sob vigência de monoartrite na fase aguda e crônica ativa. Concluímos que: 1) a ATM mostra-se densamente inervada por fibras nervosas simpáticas (TH/NPY-IR e TH/NPY/VIP-IR) e, por uma discreta quantidade de fibras nervosas parassimpáticas (VIP-IR), ambas predominantemente associadas com vasos sanguíneos; 2) o Sp5C e a PAG, mostra-se intensamente ativados em todas as fases da monoartrite no CATM, ao passo que a maioria dos centros nervosos moduladores da dor apresentam uma quantidade aumentada de neurônios imunoarreativos ao marcador de ativação neuronal, Fos, apenas durante as fases aguda e crônica ativa dessa monoartrite.The goals of the present study were: 1) to analyse the distribution of autonomic nerve fibers in the rat temporomandibular joint (TMJ) under normal conditions using immunofluorescence method to detect tirosyne hydroxylase (TH), neuropetide Y (NPY) and vasoactive intestinal polypeptide (VIP); 2) to verify the detailed distribution of autonomic nerve fibers in the rat temporomandibular joint by transmission electron microscopy; 3) to determine the neuronal activation pattern in the trigeminal system and in the pain modulation centers during monoarthritis induced in the rat temporomandibular joint complex (TMJC). For the first purpose, histologic sections from TMJs with intact innervation or with surgical sympatectomy and/or parasympathectomy were submitted to simultaneous detection of TH, NPY and VIP. For the second purpose, 5-hydroxidopamine treatment to detect sympathetic nerve endings was combined with surgical parasympatectomy of the otic ganglion to detect degenerated parasympathetic nerve endings in the rat TMJC, by transmission electron microscopy. For the last purpose, monoarthritis (acute, chronic and chronic-active phases) was induced in the TMJC and histologic sections from the brain stem were submitted to immunodetection of Fos protein in the trigeminal system and in the pain modulation centers (periqueductal gray matter - PAG; rostroventromedial medulla - RVM; locus coeruleus- LC; caudal ventrolateral medulla- CVLM; nucleus of the solitary tract - NTS; ventral reticular nucleus - VRN). The most important results demonstrated that the TMJC showed a discrete parasympathetic innervation (VIP-IR), while the sympathetic innervation was dense and characterized by TH-/NPY-/VIP-IR or TH-/NPY-IR nerve fibers. Autonomic nerve fibers were mainly noted associated to blood vessels and occasionally disperse in the synovial membrane. Fos-IR neurons showed significant bilateral increase in the spinal trigeminal caudal subnucleus and PAG during arthritis evolution. On the other hand, RVM, LC, CVLM and NTS only showed significant increase of Fos-IR neurons during the acute and chronic-active phases of monoarthritis. The main conclusions were: 1) the TMJC shows a dense sympathetic innervation (TH/NPY-IR or TH-/NPY-/VIP-IR) and discrete parasympathetic innervation (VIP-IR), both associated mainly to blood vessels; 2) most modulation pain centers are activated principally during acute and chronic-active arthritis, while the spinal trigeminal caudal subnucleus and PAG showed continuous activation during all phases of arthritis.
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Pinto, Magali Luci [UNIFESP]. "Organização Topográfica e Quantificação das Vias Trigêmino-Rubrais em Camundongos Distróficos e Normais." Universidade Federal de São Paulo (UNIFESP), 2008. http://repositorio.unifesp.br/handle/11600/9886.
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Publico-10874.pdf: 336312 bytes, checksum: bde3d9f65dc223d46e21349b3e3c3fee (MD5)Pacientes com distrofia muscular de Duchenne apresentam alteracoes no sistema nervoso central (SNC). Mudancas no SNC tambem ocorrem nos camundongos distroficos (mdx), incluindo perda de fibras rubro-espinais. Para examinar se outras vias tambem sao reduzidas no mdx, propusemo-nos a estudar a organizacao topografica das vias trigemino-rubrais e quantificar os neuronios do Complexo Trigeminal que se projetam para o nucleo Rubro em camundongos C57BL10 (normais) e distroficos (mdx) de diferentes idades. Para tanto, os animais foram submetidos a cirurgia estereotaxica para as injecoes dos tracadores de transporte retrogrado Fluorogold, Rodamina e Fluoresceina, bilateralmente, no nucleo Rubro. Sete dias depois, os animais foram sacrificados sob anestesia atraves de perfusao transcardiaca e os encefalos foram congelados em meio de embebicao proprio no uso do aparelho criostato e, destes encefalos foram realizados cortes seriados na espessura de 35 ƒÊm. A analise foi realizada em microscopico de epifluorescencia. Foram contados os neuronios do subnucleo oral do nucleo espinal do nervo trigemeo em camundongos normais e distroficos de 3, 6 e 12 meses de idade. No Sistema Intersticial, foram contados todos os neuronios marcados ao longo de sua extensao. Nossos resultados mostraram que existe uma organizacao topografica na projecao dos neuronios do Complexo Trigeminal e do Sistema Intersticial para o nucleo Rubro, em camundongos. Todos os nucleos sensoriais do Complexo Trigeminal apresentaram intensa marcacao bilateral, com predominio contralateral quando o sitio de injecao foi na regiao magnocelular do nucleo Rubro; os neuronios apresentaram pouca ou nenhuma marcacao quando o sitio atingiu a região parvocelular e, quando o sítio de injeção atingiu a região intermediária do núcleo a qual abrange suas partes magnocelular e parvocelular, a marcação retrógrada foi mais intensa só quando o foco do sítio atingiu mais a região magnocelular. O núcleo motor do Complexo Trigeminal não foi marcado em nenhuma das situações. No Sistema Intersticial, foram marcados os neurônios apenas quando o sítio de injeção abrangeu a região magnocelular do núcleo Rubro. Também foi verificado que no Complexo Trigeminal essa organização é semelhante em ambos os grupos normais e distróficos. Os resultados mostraram uma redução de 50% no número de neurônios do Complexo Trigeminal no mdx com a idade de 3 meses. Essa redução neuronal se manteve nos camundongos mdx nos grupos de 6 e 12 meses, não ocorrendo progressão desta perda com a idade. Além disso, o grupo de camundongos C57BL10 (normais) também não apresentou perda neuronal com a idade. Concluímos que a diferença observada no complexo trigeminal no grupo de 3 meses já está estabelecida e que não é progressiva com o avanço da idade; portanto, é bem provável que os camundongos mdx já nasçam com essa redução ou que a mesma ocorra logo nas primeiras semanas após o nascimento.
TEDE
BV UNIFESP: Teses e dissertações
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Melin, Céline. "Rôle de l'inhibition segmentaire dans le traitement de l'information nociceptive cutanée et méningée dans le complexe trigéminal." Thesis, Clermont-Ferrand 1, 2011. http://www.theses.fr/2011CLF1DD01/document.
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Une réduction de l'inhibition segmentaire contribue vraisemblablement à l'hypersensibilité douloureuse persistante – qui se manifeste par l'hyperalgie, l'allodynie, et la douleur spontanée – au cours d'états douloureux chroniques. L'association fréquente d'une allodynie avec la migraine – une céphalée épisodique – suggère qu'une perte de l'inhibition synaptique contribue aussi à la manifestation de la douleur migraineuse. Cependant, la grande prévalence de la migraine – plus de 10% de la population générale – soulève la question de savoir si le traitement des informations méningées par le réseau neuronal – associant interneurones excitateurs et inhibiteurs – dans le complexe trigéminal, premier relais sur les voies nociceptives de la face et des méninges, est le même que celui des autres informations, par exemple cutanées. Nous avons caractérisé l'effet du blocage pharmacologique des récepteurs à la glycine (GlyR) et des récepteurs GABAA (GABAAR) sur la transmission synaptique entre fibres afférentes primaires, cutanées ou méningées, et neurones de second ordre en enregistrant des potentiels de champ dans le sous-noyau caudal superficiel (Sp5C). Une stimulation électrique transcutanée évoque trois potentiels de champ négatifs dus à l'activation, du plus précoce au plus tardif, de fibres afférentes primaires de type Aβ, Aδ et C. Bloquer les GlyRs et/ou GABAARs segmentaires facilite les potentiels de champ polysynaptiques excitateurs évoqués par l'activation des fibres afférentes primaires de type A et, au contraire, inhibe, ou même abolit, les potentiels de champ C. Bloquer les récepteurs GABAB (GABABR) segmentaires prévient cette suppression. Il est intéressant de noter que bloquer les GABABRs, potentialise aussi les potentiels de champ C en condition controle. Une stimulation électrique méningée évoque deux potentiels de champ négatifs dus à l'activation, du plus précoce au plus tardif, des fibres afférentes primaires de type Aδ et C. Au contraire du potentiel de champ C cutané, le potentiel de champ C méningé est potentialisé après blocage des GlyRs et/ou GABAARs segmentaires. Ces résultats démontrent que le traitement des informations cutanées et méningées par le Sp5C est différent. Seule l'activation des fibres afférentes primaires cutanées de type A inhibe les inputs cutanés de type C vers le Sp5C par l'intermédiaire d'un circuit polysynaptique excitateur, d'interneurones GABAergiques de dernier ordre et de GABABRs présynaptiques. La théorie du "gate control" postule que l'activité des afférences non-nociceptives ferme la porte à la transmission des inputs nociceptifs vers les centres supérieurs. Nos résultats suggèrent que l'état de la porte dépend de l'activité non seulement dans les fibres afférentes primaires de type A mais aussi dans les circuits polysynaptiques excitateurs de la corne dorsalePathological disruption of segmental inhibition is thought to contribute to persistent pain hypersensitivity – including hyperalgesia, allodynia and spontaneous pain – that occurs during chronic pain states. That allodynia is also often associated with migraine – an episodic headache – suggests that a loss of synaptic inhibition is also involved in the manifestation of headache pain. However, the very high prevalence of migraine – more than 10% of the general population – raises the question as to whether processing of meningeous inputs by local neuronal network – consisting of excitatory and inhibitory interneurons – within the trigeminal nucleus, the first relay station for incoming nociceptive signals of the face and meninges, is the same as that of others, for instance cutaneous. We sought to characterize how pharmacological blockade of glycine and GABAA receptors modifies synaptic transmission between either cutaneous or meningeous primary afferent fibers and second order neurons by recording field potentials in the rat superficial medullary dorsal horn (MDH). Transcutaneous electrical stimulation evokes three negative field potentials elicited by, from the earliest to the latest, Aβ-, Aδ- and C-fiber primary afferents. Blocking segmental glycine and/or GABAA receptors strongly facilitates A-fiber-activated polysynaptic excitatory field potentials but, conversely, inhibits, or even abolishes, C-fiber field potentials. Blocking segmental GABAB receptors reverses such suppression. Interestingly, it also potentiates C-fiber field potentials under control conditions. Meningeous electrical stimulation evokes two negative field potentials elicited by, from the earliest to the latest, Aδ- and C-fiber primary afferents. Unlike cutaneous C-fiber field potentials, meningeous ones are facilitated by blocking segmental glycine and/or GABAA receptors. These results demonstrate that MDH processing of cutaneous and meningeous inputs are different. Only activation of cutaneous A-fiber primary afferents inhibits cutaneous C-fiber inputs to the MDH by the way of polysynaptic excitatory pathways, last-order GABAergic interneurons and presynaptic GABAB receptors. In view of the gate control theory postulating that afferent volleys in non-nociceptive afferents close the gate to central transmission of nociceptive inputs, our results suggest that the state of the gate depends on firing activities of both A-fiber primary afferents and polysynaptic excitatory circuits, i.e. the inhibitory tone, within the dorsal horn
Books on the topic "Trigeminal complex"
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Shaw, Pamela, and David Hilton-Jones. The lower cranial nerves and dysphagia. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198569381.003.0429.
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Disorders affecting the lower cranial nerves – V (trigeminal), VII (facial), IX (glossopharyngeal), X (vagus), XI (accessory) and XII (hypoglossal) – are discussed in the first part of this chapter. The clinical neuroanatomy of each nerve is described in detail, as are disorders – often in the form of lesions – for each nerve.Trigeminal nerve function may be affected by supranuclear, nuclear, or peripheral lesions. Because of the wide anatomical distribution of the components of the trigeminal nerve, complete interruption of both the motor and sensory parts is rarely observed in practice. However, partial involvement of the trigeminal nerve, particularly the sensory component, is relatively common, the main symptoms being numbness and pain. Reactivation of herpes zoster in the trigeminal nerve (shingles) can cause pain and a rash. Trigeminal neuralgia and sensory neuropathy are also discussed.Other disorders of the lower cranial nerves include Bell’s palsy, hemifacial spasm and glossopharyngeal neuralgia. Cavernous sinus, Tolosa–Hunt syndrome, jugular foramen syndrome and polyneuritis cranialis are caused by the involvement of more than one lower cranial nerve.Difficulty in swallowing, or dysphagia, is a common neurological problem and the most important consequences include aspiration and malnutrition (Wiles 1991). The process of swallowing is a complex neuromuscular activity, which allows the safe transport of material from the mouth to the stomach for digestion, without compromising the airway. It involves the synergistic action of at least 32 pairs of muscles and depends on the integrity of sensory and motor pathways of several cranial nerves; V, VII, IX, X, and XII. In neurological practice dysphagia is most often seen in association with other, obvious, neurological problems. Apart from in oculopharyngeal muscular dystrophy, it is relatively rare as a sole presenting symptom although occasionally this is seen in motor neurone disease, myasthenia gravis, and inclusion body myositis. Conversely, in general medical practice, there are many mechanical or structural disorders which may have dysphagia as the presenting feature. In some of the disorders, notably motor neurone disease, both upper and lower motor neurone dysfunction may contribute to the dysphagia. Once dysphagia has been identified as a real or potential problem, the patient should undergo expert evaluation by a clinician and a speech therapist, prior to any attempt at feeding. Videofluoroscopy may be required. If there is any doubt it is best to achieve adequate nutrition through the use of a fine-bore nasogastric tube and to periodically reassess swallowing. Anticholinergic drugs may be helpful to reduce problems with excess saliva and drooling that occur in patients with neurological dysphagia, and a portable suction apparatus may be helpful. Difficulty in clearing secretions from the throat may be helped by the administration of a mucolytic agent such as carbocisteine or provision of a cough assist device.
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El-Kadri, Moutaz, and George Hart. Extrasystoles. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0110.
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An extrasystole is a cardiac electrical impulse (often premature) which is not part of the normal heart rhythm. Extrasystoles most frequently arise from the ventricles and are then called ventricular extrasystoles, or premature ventricular complexes. Less often, they originate from the atria, the atrioventricular junction or, rarely, from the sinus node—these are termed supraventricular extrasystoles. The term ‘bigeminy’ refers to an extrasystole every second beat, and ‘trigeminy’, every third beat. Two successive extrasystoles are called a ‘couplet’; three are called a ‘triplet’. Extrasystoles with varying morphology are described as ‘polymorphic’ or ‘multifocal’, whereas those maintaining the same morphology are termed ‘unifocal’.
Book chapters on the topic "Trigeminal complex"
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Ehland, Elise L., Roger A. Meyer, and Shahrokh C. Bagheri. "Trigeminal Nerve Injuries." In Complex Dental Implant Complications, 217–37. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-47012-8_9.
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Shigenaga, Yoshio, and Atsushi Yoshida. "Trigeminal Brainstem Nuclear Complex, Anatomy." In Encyclopedia of Pain, 4054–60. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-28753-4_4602.
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Hu, James W., and Alain Woda. "Trigeminal Brainstem Nuclear Complex, Physiology." In Encyclopedia of Pain, 4060–65. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-28753-4_4604.
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Bereiter, David A. "Trigeminal Brain Stem Nuclear Complex, Immunohistochemistry, and Neurochemistry." In Encyclopedia of Pain, 4050–53. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-28753-4_4603.
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"34 Large Trigeminal Neurinoma." In Neurosurgery of Complex Vascular Lesions and Tumors, edited by Shigeaki Kobayashi. Stuttgart: Georg Thieme Verlag, 2005. http://dx.doi.org/10.1055/b-0034-55524.
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Srivastava, Devjit, and Manohar Sharma. "Trigeminal interventions for head and neck cancer pain." In Practical Management of Complex Cancer Pain, 239–50. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199661626.003.0019.
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Gozalov, Aydin, Messoud Ashina, and Joanna M. Zakrzewska. "Cranial neuralgias and persistent idiopathic facial pain." In Oxford Textbook of Headache Syndromes, edited by Michel Ferrari, Joost Haan, Andrew Charles, David W. Dodick, Fumihiko Sakai, and Christopher Kennard, 237–47. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198724322.003.0027.
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Orofacial pain is a complex problem and affects up to 7% of the population. Although trigeminal neuralgia has been considered the prime neuralgic condition in the facial region, other forms of neuropathic pain are now being more frequently recognized and require recognition and a different management approach. Many patients with chronic orofacial pain report numerous comorbidities, such as psychiatric or personality disorders, which significantly affect management. Various pain conditions present in the facial region. Some of them rarely present extra-orally (unless as radiating pain) such as atypical odontalgia or persistent dento-alveolar pain disorder and burning mouth syndrome, whereas others will present in both areas such as classical trigeminal neuralgia, post-traumatic trigeminal neuropathy, trigeminal neuropathy attributed to multiple sclerosis, and persistent idiopathic facial pain. Myofascial pain syndrome related to the muscles of mastication is very common and may also be associated with temporomandibular joint problems. Trigeminal neuralgia and the rarer glossopharyngeal neuralgia are similar in quality and characteristics with specific treatment modalities, but differ in pain location. Trigeminal neuropathic pain is caused most frequently by trauma. If no other diagnostic criteria are fulfilled, a diagnosis of persistent idiopathic facial pain is made. It is crucial for these patients to be managed by multidisciplinary teams.
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Theofanis, Thana N., and Patrick Greaney. "Management of Complex Scalp Injuries." In Neurotrauma, 177–86. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190936259.003.0020.
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Complex scalp wounds require an understanding of basic anatomy and a broad knowledge of options for surgical repair. The scalp is comprised of five layers: skin, subcutaneous fat, galea aponeurotica, loose areolar tissue, and pericranium. The vascular supply is provided from vessels branching primarily off the external carotid artery. Sensation is provided by the trigeminal and C2–C3 nerves. A surgical team should evaluate all full-thickness and complex scalp lacerations, especially those associated with underlying skull fractures. Complications include wound dehiscence and infection. Clinicians must remain extremely vigilant in following these patients because an infection can lead to underlying osteomyelitis of the skull, meningitis, or subdural empyema. Often, multiple surgical teams may be involved, and a planned stepwise approach may provide the best outcome for the patient.
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Wu, Jiang, and Jianguo Cheng. "Interventional Treatment of Neuropathic Pain." In Neuropathic Pain, edited by Jianguo Cheng, 53–62. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190298357.003.0007.
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Neuropathic pain has been reported to be highly prevalent, severely disabling, and often refractory to pharmacological and noninterventional conservative treatment. There is an emerging body of exciting evidence to support interventional therapies in selected refractory neuropathic pain states, although more randomized controlled trials or comparative effective trials are needed. This chapter updates the scientific evidence in support of the efficacy of neural blockade techniques and neural ablative procedures in neuropathic pain states, including peripheral compression or trauma-related neuropathic pain, herpes zoster and postherpetic neuralgia (PHN), lumbosacral and cervical radiculopathy, sympathetically maintained pain, complex regional pain syndrome (CRPS), trigeminal neuralgia and trigeminal neuropathy, and painful diabetic polyneuropathies.
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Abbott, Jillie, Claire Patterson, and Elena Semino. "Patient support groups." In Trigeminal Neuralgia and Other Cranial Neuralgias, 207–16. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198871606.003.0017.
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The Trigeminal Neuralgia Association (now the Facial Pain Association) was formed in 1990 in the USA. A network of similar support groups exists around the world to educate both professionals and patients, raise awareness, and allow patients with trigeminal neuralgia to meet and provide mutual support and share information. These groups provide telephone and email helplines, giving 24-hour assistance. As technology has evolved, these groups now hold online meetings and provide moderated forums for discussion, but face-to-face contact is still vital, as demonstrated by feedback from local meetings and national and international conferences. Analysis of material posted on a UK members online forum shows how patients feel their experiences are validated and that the personal support they receive reduces their isolation and fear. Printed resources and websites can be shared with others for mutual understanding of this complex disorder, and to educate employers. The education gained from networking with others gives patients empowerment and enables them to work in closer partnership with their healthcare professionals.
Conference papers on the topic "Trigeminal complex"
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Pavlov, Alexey N., Anatoly N. Tupitsyn, Valery A. Makarov, Fivos Panetsos, Angel Moreno, Victor Garcia-Gonzalez, and Abel Sanchez-Jimenez. "Tactile information processing in the trigeminal complex of the rat." In Biomedical Optics (BiOS) 2007, edited by Valery V. Tuchin. SPIE, 2007. http://dx.doi.org/10.1117/12.709155.
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Albuquerque, Júlia Elizabeth Nagrad de Farias, Byanka Eduarda Silva de Arruda, Fernando de Paiva Melo Neto, and Francisco Nêuton de Oliveira Magalhães. "Analysis of care in neurosurgery outpatient clinic in Paraíba." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.277.
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Background: Currently the public health system encompasses numerous demands, including in the neurology and neurosurgery sector. The wide outpatient search shows several symptoms, with pain being one of the most prominent. Objectives: To analyze the consultations performed in a neurosurgery clinic, aiming to understand the main demands found at secondary health care. Design and setting: Retrospective and descriptive study, conducted through the analysis of data from a neurosurgery outpatient clinic in the state of Paraíba Methods: Conducted through the analysis of data from 73 patients relative to a neurosurgery outpatient clinic, during the period between 11/24/2020 and 12/15/2020. The variables were: gender, age and diagnostic suspicion. Results: A predominance of females was found (65.7%) and, among all patients, the youngest patient was 8 years old and the oldest was 83 years old. Among the patients, it was possible to observe an important presence of Headache (28.7%), followed by Back Pain (17.7%) and Psychiatric disorders (6.9%), the other patients presented several diagnoses, such as Cerebellar Syndrome (1.37%) and Neoplasms (5.5%). There was found male predominance in Sequelae of Stroke, Parkinson’s Disease, Spinal Pathologies, Autism, Brachial Plexus Injury, Carpal Tunnel Syndrome and Complex Painful Syndrome. Furthermore, it was noted equivalence of occurrence in both sexes of Neuropathic Pain, Convulsion, Post- Herpetic Neuralgia and Trigeminal Neuralgia. Conclusion: The search for regional standards and their comparison to the world scenario is important to assist in clinical diagnosis, besides helping in the allocation of resources and studies.
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Maia, Matheus Goncalves, Vivian Dias Baptista Gagliardi, Francisco Tomaz Meneses Oliveira, Eduardo dos Santos Sousa, Marina Trombin Marques, Leonardo de Sousa Bernardes, and Edson Júnior Gonçalves Bechara. "Trigeminal Neuralgia associated with Wallenberg Syndrome, a case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.580.
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Context: Trigeminal neuralgia is typically associated with structural lesions that affect the brainstem, pre-ganglionic roots, gasserian ganglion and the trigeminal nerve. The association of trigeminal neuralgia with infarction of the dorsolateral medulla is rare, being more associated with pontine lesions, in the context of brainstem infarction. Methods: Report the case of a 55-year-old male patient, who presented with a left dorsolateral bulbar infarction, and developed a ipsilateral trigeminal neuralgia afterwards. Case report: A 55-year-old man attended to the emergency room referring sudden incoordination of the left limbs, associated with numbness of the contralateral limbs. The neurological examination showed nystagmus, numbness of the left face, ataxia of the left limbs and numbness of the right limbs. The Magnetic Resonance of the Brain revealed an area of recent infarction in the left posterolateral aspect of the medulla. He underwent thrombolysis, evolving with complete resolution of symptoms. In the week after the initial event, he returned to the outpatient clinic, reporting paroxysms of excruciating pain in the upper lip, nose and left zygomatic region, being diagnosed with neuralgia of the maxillary segment of the trigeminal nerve, improving with introduction of Gabapentin. Conclusion: Although most cases of trigeminal neuralgia are determined by vascular compression of the trigeminal nerve root entry zone, other causes must be considered. The association of this condition with dorsolateral medulla infarction is rare, with only 4 cases reported in the last 10 years.
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Manzato, Luciano Bambini, José Ricardo Vanzin, Octávio Ruschel Karam, Artur Eduardo Martio, Victor Emanuel Angeliero, Luiza Rech Köhler, Paulo Moacir Mesquita Filho, Saulo de Azeredo, Yasmynni Escher, and Emanuel Kerber. "Successful Endovascular Treatment of Trigeminal Neuralgia Caused by a Carotid-Cavernous Fistula: Case Report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.062.
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Context: Dural arteriovenous fistulas (DAVFs) of the cavernous sinus are arteriovenous connections located in the dura mater leaflets of this region. DAVFs usually present with ocular symptoms such as diplopia, conjunctival hyperemia, involvement of cranial nerves III/IV/VI, etc. Trigeminal neuralgia caused by a cavernous DAVF is rare, being reported only three times in the literature. Case report: A 46-year-old female smoker sought care with a complaint of multiple daily episodes of shock-like right temporal headache and facial pain in the V1/V2 dermatomes, of 2 years’ duration. A clinical diagnosis of trigeminal neuralgia was established. Magnetic resonance (MR) imaging of the brain and MR angiography of the cerebral and cervical vessels were both normal. Conservative treatment and balloon compression of the trigeminal ganglion were ineffective. Therefore, we chose to perform an angiography for diagnostic clarification, which demonstrated a DAVF of the right cavernous sinus, fed by branches of the external carotid artery. We decided to catheterize the fistula and complete obliteration was achieved. Soon after the procedure the patient reported pain relief. At 3-month follow-up the patient remained pain free and required no analgesia. Conclusion: Trigeminal neuralgia caused by a cavernous DAVF is rare. The fistula in this case was only diagnosed after an angiography was performed, so clinicians must be aware that not all vascular conditions can be identified non invasively, and that cavernous DAVFs may be an underdiagnosed cause of trigeminal neuralgia.
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Barile, João Paulo, Amanda Freitas Alves, Fernanda Maria Gonçalves de Sousa Moura, Sonia Maria Cesar de Azevedo Silva, and Roberta Arb Saba Rodrigues Pinto. "Tolosa Hunt syndrome, case report." In XIV Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2023. http://dx.doi.org/10.5327/1516-3180.141s1.317.
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Introduction: Tolosa Hunt syndrome (THS) is a rare condition, incidence of 1/1.000.000 case per year, characterized by unilateral painful ophthalmoparesis caused by idiopathic inflammation in the cavernous sinus. The oculomotor nerve is most commonly involved (80%), followed by abducens nerve (70%), ophthalmic branch of trigeminal nerve (30%), trochlear nerve (29%). Case presentation: Male, 77 years old, admitted with an acute moderate-intensity orbitofrontal headache on the left, envolving with palpebral ptosis of the left eye. Neurological examination: complete palpebral ptosis on the left and ophthalmoplegia of the entire ipsilateral extrinsic ocular musculature. A complete investigation was carried out: metabolic, rheumatological, serological tests without significant alterations and study of the cerebrospinal fluid with mild hyperproteinorachia, without pleocytosis. Magnetic resonance imaging (MRI) of the skull showed thickening of the cavernous sinus on the left, with contrast enhancement; Angio-MRI of the Skull and Neck without alterations. Therefore, THS was diagnosed and treatment with Methylprednisolone 1 g for five days, with complete improvement of headache and partial improvement of ophthalmoparesis. The patient was discharged with 60 mg of prednisone orally with instructions for gradual weaning off, return to the neurology outpatient clinic. Discussion: THS diagnosis is based on the International Classification of Headache Disorders: unilateral periorbital headache; granulomatous inflammation of the cavernous sinus, superior orbital fissure or orbit on cranial MRI; paralysis of one or more of the oculomotor nerves; the headache must precede the ophthalmoparesis by up to two weeks or appear concomitantly. The exclusion of secondary causes is essential. Treatment of choice is cortico steroids, improvement of headache in the first days, and of ophthalmoparesis in 2–8 weeks. Conclusion: Unilateral headache with ipsilateral ophthalmoparesis should raise the suspicion of THS.