Статті в журналах: "Trigeminal complex"

1

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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2

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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3

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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4

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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5

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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6

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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7

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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8

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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9

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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10

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.

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Gajski, Domagoj, Alicia Dennis, and Kenan Arnautović. "Microsurgical Decompression of Trigeminal Neuralgia Caused by Simultaneous Double Arterial (SCA and AICA) and Petrosal Vein Complex Compression." Journal of Neurological Surgery Part B: Skull Base 79, S 05 (September 25, 2018): S428—S430. http://dx.doi.org/10.1055/s-0038-1669968.

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Trigeminal neuralgia is a chronic pain disorder affecting the face. In approximately 80% of cases, it is most commonly caused, when the root entry zone (REZ) of the trigeminal nerve is compressed by the superior cerebellar artery (SCA). The etiology of the remaining 20% of cases is distributed among venous, arteriovenous malformations, posterior fossa tumors, multiple sclerosis plaque compressions, and other pathologies. Combinations of those compressive factors are very rare.1 2 3 4 Herein, we present a video clip of microvascular decompression (MVD) in a 73-year-old female, who has failed conservative treatment with 6 medications over 10 years. She was affected by a unique triple compression of the right REZ by the SCA, anterior inferior cerebellar artery (AICA), and petrosal vein complex (Fig. 1A). Right-sided microsurgical decompression of the REZ of the trigeminal nerve through standard retrosigmoid craniotomy was performed by the senior author (K.I.A.). The SCA and AICA were separated from the nerve using Teflon pledgets. The petrosal vein complex was coagulated and divided, freeing up the right trigeminal nerve (Fig. 1B). The patient was discharged home on the third postoperative day with complete resolution of trigeminal neuralgia.The link to the Video can be found at: https://youtu.be/PYVvImGW0yE.

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12

Terrier, Louis‐Marie, Nouchine Hadjikhani, Stéphane Velut, Caroline Magnain, Aymeric Amelot, Florian Bernard, Lilla Zöllei, and Christophe Destrieux. "The trigeminal system: The meningovascular complex— A review." Journal of Anatomy 239, no. 1 (February 18, 2021): 1–11. http://dx.doi.org/10.1111/joa.13413.

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13

Jacquin, Mark F., Nicolas L. Chiaia, John H. Haring, and Robert W. Rhoades. "Intersubnuclear Connections within the Rat Trigeminal Brainstem Complex." Somatosensory & Motor Research 7, no. 4 (January 1990): 399–420. http://dx.doi.org/10.3109/08990229009144716.

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14

LaVail, Jennifer H., Junni Zhan, and Todd P. Margolis. "HSV (Type 1) infection of the trigeminal complex." Brain Research 514, no. 2 (April 1990): 181–88. http://dx.doi.org/10.1016/0006-8993(90)91414-c.

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15

Chen, QiLiang, Dae Ik Yi, Josiah Nathan Joco Perez, Monica Liu, Steven D. Chang, Meredith J. Barad, Michael Lim, and Xiang Qian. "The Molecular Basis and Pathophysiology of Trigeminal Neuralgia." International Journal of Molecular Sciences 23, no. 7 (March 25, 2022): 3604. http://dx.doi.org/10.3390/ijms23073604.

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Trigeminal neuralgia (TN) is a complex orofacial pain syndrome characterized by the paroxysmal onset of pain attacks in the trigeminal distribution. The underlying mechanism for this debilitating condition is still not clearly understood. Decades of basic and clinical evidence support the demyelination hypothesis, where demyelination along the trigeminal afferent pathway is a major driver for TN pathogenesis and pathophysiology. Such pathological demyelination can be triggered by physical compression of the trigeminal ganglion or another primary demyelinating disease, such as multiple sclerosis. Further examination of TN patients and animal models has revealed significant molecular changes, channelopathies, and electrophysiological abnormalities in the affected trigeminal nerve. Interestingly, recent electrophysiological recordings and advanced functional neuroimaging data have shed new light on the global structural changes and the altered connectivity in the central pain-related circuits in TN patients. The current article aims to review the latest findings on the pathophysiology of TN and cross-examining them with the current surgical and pharmacologic management for TN patients. Understanding the underlying biology of TN could help scientists and clinicians to identify novel targets and improve treatments for this complex, debilitating disease.

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Du, Rose, Devin K. Binder, Van Halbach, Nancy Fischbein, and Nicholas M. Barbaro. "Trigeminal Neuralgia in a Patient with a Dural Arteriovenous Fistula in Meckel's Cave: Case Report." Neurosurgery 53, no. 1 (July 1, 2003): 216–21. http://dx.doi.org/10.1227/01.neu.0000069535.42897.1f.

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Abstract OBJECTIVE AND IMPORTANCE Trigeminal neuralgia is often the result of vascular compression at the root entry zone of the trigeminal nerve. We report a case of trigeminal neuralgia in a patient with a dural arteriovenous fistula in Meckel's cave. Endovascular closure of the fistula resulted in elimination of the patient's pain at the gasserian ganglion level. CLINICAL PRESENTATION A 77-year-old woman was referred for treatment of trigeminal neuralgia after failed conservative treatment, including multiple gasserian ganglion blocks. Magnetic resonance imaging of the brain suggested a vascular lesion, and cerebral angiography demonstrated a dural arteriovenous fistula in Meckel's cave. INTERVENTION Endovascular coil embolization was performed, with obliteration of the dural arteriovenous fistula and resolution of facial pain but with decreased sensation in the face. CONCLUSION Trigeminal neuralgia may be associated with complex vascular lesions around the base of the brain and along the course of the trigeminal nerve. The evaluation of patients with trigeminal neuralgia should include high-quality, thin-section, magnetic resonance imaging scans, to exclude the possibility of vascular lesions and other structural lesions. In particular, patients who are being evaluated for surgical treatment of trigeminal neuralgia should undergo magnetic resonance imaging, with a focus on the course of the trigeminal nerve.

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Tanashyan, M. M., M. Yu Maksimova, S. Yu Ivanov, E. M. Musaeva, and P. A. Fedin. "Trigeminal neuropathy following orthognathic surgery." Neurology, Neuropsychiatry, Psychosomatics 12, no. 4 (August 27, 2020): 37–42. http://dx.doi.org/10.14412/2074-2711-2020-4-37-42.

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Traumatic trigeminal neuropathy occupies a special place in the pain continuum. The clarification of genesis and clinical and neurophysiological findings makes it possible to perform differentiation treatment.Objective: to evaluate the clinical and neurophysiological efficiency of repetitive magnetic stimulation (RMS) and vitamin B complex therapy for traumatic trigeminal neuropathy.Patients and methods. The investigation enrolled 36 patients (26 women and 10 men) aged 25 to 35 years with inferior alveolar neuropathy following bilateral sagittal split osteotomy. The DN4 questionnaire was used to identify a neurogenic pain component. The intensity of pain syndrome was assessed using a visual analogue scale. A neurophysiological examination involving the recording of brainstem auditory evoked potentials (BAEPs) and trigeminal evoked potentials (TEPs) was made using a Neuro-MEP device (Neurosoft, Russia). Therapy including vitamin B complex was performed in 12 patients. Twenty-four patients received low-frequency pulsed magnetic field therapy using a Neuro-MS magnetic stimulator.Results and discussion. The clinical picture in patients with traumatic inferior alveolar neuropathy after corrective mandible surgery is characterized by the polymorphism of pain sensations and sensory disorders. The development of pain syndrome is due to a neuropathic component. The 10-day vitamin group B therapy cycle had no substantial impact on the time course of clinical and neurophysiological changes. After the 10-day RMS cycle, there were reductions in swelling and the intensity of pain syndrome and the severity of sensory disorders in the lower lip, chin, and mandible. The data on BAEPs showed shortening in the interpeak intervals III–V; those on TEPs demonstrated a decrease in the P1–N1 amplitude.Conclusion. Unlike vitamin B complex therapy, the RMS cycle in patients with traumatic trigeminal neuropathy makes it possible to reduce the intensity of pain syndrome and the severity of sensory disorders, as well as excitability of the nonspecific structures of the brainstem and the central structures of the trigeminal system.

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Fu, Jia, Guo Mu, Ling Qiu, Jiaomei Zhao та Cehua Ou. "c-Abl-p38α signaling pathway mediates dopamine neuron loss in trigeminal neuralgia". Molecular Pain 16 (січень 2020): 174480692093085. http://dx.doi.org/10.1177/1744806920930855.

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Trigeminal neuralgia is a common neuropathic pain in the head and face. The pathogenesis of trigeminal neuralgia is complex, and so far, the pathogenesis of trigeminal neuralgia involving peripheral and central nervous inflammation theory has not been explained clearly. The loss of dopamine neurons in striatum may play an important role in the development of trigeminal nerve, but the reason is not clear. C-Abl is a nonreceptor tyrosine kinase, which can be activated abnormally in the environment of neuroinflammation and cause neuron death. We found that in the rat model of infraorbital nerve ligation trigeminal neuralgia, the pain threshold decreased, the expression of c-Abl increased significantly, the downstream activation product p38 was also activated abnormally and the loss of dopamine neurons in striatum increased. When treated with imatinib mesylate (STI571), a specific c-Abl family kinase inhibitor, the p38 expression was decreased and the loss of dopaminergic neurons was reduced. The mechanical pain threshold of rats was also improved. In conclusion, c-abl-p38 signaling pathway may play an important role in the pathogenesis of trigeminal neuralgia, and it is one of the potential targets for the treatment of trigeminal neuralgia.

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Furuta, Takahiro, Elena Timofeeva, Keiko Okamoto-Furuta, Martin Deschenes, Kouichi Nakamura, and Takeshi Kaneko. "Inhibitory input from the interpolar nucleus of the spinal trigeminal complex to the principal trigeminal nucleus." Neuroscience Research 58 (January 2007): S160. http://dx.doi.org/10.1016/j.neures.2007.06.661.

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20

Ito, G., Y. Suekawa, M. Watanabe, K. Takahashi, T. Inubushi, K. Murasaki, N. Hirose, S. Hiyama, T. Uchida, and K. Tanne. "P2X7receptor in the trigeminal sensory nuclear complex contributes to tactile allodynia/hyperalgesia following trigeminal nerve injury." European Journal of Pain 17, no. 2 (August 3, 2012): 185–99. http://dx.doi.org/10.1002/j.1532-2149.2012.00174.x.

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21

Zhu, Zhenghong, Heather R. Bowman, Helen A. Baghdoyan, and Ralph Lydic. "Morphine Increases Acetylcholine Release in the Trigeminal Nuclear Complex." Sleep 31, no. 12 (December 2008): 1629–37. http://dx.doi.org/10.1093/sleep/31.12.1629.

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Satoh, Toru, Keisuke Onoda, and Isao Date. "PREOPERATIVE SIMULATION FOR MICROVASCULAR DECOMPRESSION IN PATIENTS WITH IDIOPATHIC TRIGEMINAL NEURALGIA." Neurosurgery 60, no. 1 (January 1, 2007): 104–14. http://dx.doi.org/10.1227/01.neu.0000249213.34838.c9.

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Abstract OBJECTIVE Precise assessment of the complex nerve-vessel relationship at the root entry zone of the trigeminal nerve is useful for planning microvascular decompression in patients with idiopathic trigeminal neuralgia. We have applied a fusion imaging technique of three-dimensional (3-D) magnetic resonance cisternography and co-registered 3-D magnetic resonance angiography (MRA) that allows virtual reality for the preoperative simulation of the neurovascular conflict at the trigeminal nerve root entry zone. METHODS Fusion images of 3-D magnetic resonance cisternograms and angiograms were reconstructed by a perspective volume-rendering algorithm from the volumetric data sets of magnetic resonance cisternography, obtained by a T2-weighted 3-D fast spin echo sequence, and co-registered MRA, by a 3-D time-of-flight sequence. Consecutive series of 12 patients with idiopathic trigeminal neuralgia were studied with fusion 3-D magnetic resonance cisternogram and MRA in the preoperative assessment for the microvascular decompression of the affected trigeminal nerve. RESULTS The complex anatomical relationship of the offending vessels to the trigeminal nerve root entry zone was depicted on the fusion 3-D magnetic resonance cisternogram and MRA. The presence of offending vessels and compressive site of neurovascular conflict was assessed from the various viewpoints within the cistern and was presumed by the preoperative simulation through the surgical access (surgeon's-eye view). The blinded surgical trajectory was discerned by the virtual image through the opposite direction projected from above (bird's-eye view). The 3-D visualization of the nerve-vessel relationship with fusion images was consistent with the intraoperative trajectory and findings. CONCLUSION Fusion imaging of 3-D magnetic resonance cisternogram and MRA may prove a useful adjunct for the diagnosis and decision-making process to execute the microvascular decompression in patients with idiopathic trigeminal neuralgia.

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Shulman, H. M. "Alcoholization of the Hasser's node and sensory root from temporal access in trigeminal neuralgia." Kazan medical journal 67, no. 5 (September 15, 1986): 339–42. http://dx.doi.org/10.17816/kazmj70694.

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Trigeminal neuralgia is one of the most severe and common forms of facial pain syndrome. Its etiology is varied. Most researchers characterize trigeminal neuralgia as a complex process in which the focus of irritation in the afferent part of the nerve causes changes in the stem and subcortical structures in the form of foci of pathological activity manifested by paroxysms.

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Ishi, Yukitomo, Katsuyuki Asaoka, Taku Sugiyama, Yuka Yokoyama, Kazuyoshi Yamazaki, Sumire Echizenya, Koji Itamoto, and Kohei Echizenya. "Case Report: Trigeminal Neuralgia Caused by a Minute Meningioma with Hyperostosed Suprameatal Tubercle." Case Reports in Neurology 7, no. 2 (August 8, 2015): 167–72. http://dx.doi.org/10.1159/000438856.

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Cerebellopontine angle tumors might occasionally provoke trigeminal neuralgia but are usually large enough to be diagnosed radiographically. We present a case of trigeminal neuralgia caused by a very small meningioma covering the suprameatal tubercle that displayed hyperostosis at the entrance of Meckel's cave and was not obvious on routine magnetic resonance (MR) images. A 72-year-old woman with intractable trigeminal neuralgia in the left V3 territory was referred to our institution. Preoperative imaging studies revealed that the left trigeminal nerve was medially distorted at the entrance of Meckel's cave by a laterally seated bone bulge covered by a minute enhanced lesion. Trigeminal nerve decompression surgery was performed via a retrosigmoid intradural suprameatal approach. We found a small meningioma that had compressed and flattened the trigeminal nerve root at the entrance of Meckel's cave, which was grossly and totally removed by suprameatal tubercle resection. There was no vascular compression of the trigeminal nerve root. The trigeminal neuralgia ceased completely after the operation. Accurate preoperative determination of the causative pathologies is essential to achieve adequate surgical results after microvascular decompression for neurovascular compression syndrome. Because conventional MR sequences are inadequate for the precise interpretation of complex neurovascular anatomy in the cerebellopontine angle and such small tumors can be overlooked on routine MR studies, high-resolution thin-slice MR examinations and careful radiological interpretations are required for correct diagnosis and treatment.

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Streit, W. J., B. A. Schulte, D. J. Balentine, and S. S. Spicer. "Histochemical localization of galactose-containing glycoconjugates in sensory neurons and their processes in the central and peripheral nervous system of the rat." Journal of Histochemistry & Cytochemistry 33, no. 10 (October 1985): 1042–52. http://dx.doi.org/10.1177/33.10.4045182.

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We studied the distribution of sugar residues in the oligosaccharide chains of complex carbohydrates in tissue sections of rat spinal cord, brainstem, and sensory ganglia using twelve lectin-horseradish peroxidase conjugates. Glycoconjugates containing terminal galactose residues were localized apparently in the Golgi apparatus in a population of predominantly small B-type neurons in spinal and trigeminal ganglia. Large A-type neurons rarely showed reactivity with galactose-binding lectins. A cells stained for glycoconjugates with N-glycosidically linked oligosaccharides and glycogen. The central and peripheral processes of the small neurons, mostly unmyelinated C fibers in sensory roots and spinal nerves, contained an abundance of glycoconjugates with terminal alpha-galactose residues. The central projections and terminals of small to medium-sized primary sensory neurons in the spinal and trigeminal ganglia were visualized in Lissauer's tract and the substantia gelatinosa in the spinal cord, and in the spinal trigeminal tract and the nucleus trigeminus in the lower medulla with lectins specific for terminal alpha-galactose residues. In addition, fibers of the solitary system and the area postrema were reactive with these lectins. The peripheral and central nervous system elements with affinity for galactopyranosyl-specific lectins correspond in distribution with neuroanatomical regions thought to be involved in the transmission and relay of somatic and visceral afferent inputs such as pain and temperature. Such specific localization of a glycosubstance to a distinct subpopulation of neurons and their peripheral and central processes suggests that the particular glycoconjugate may be of physiological significance.

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Komatsu, Fuminari, Mika Komatsu, Antonio Di Ieva, and Manfred Tschabitscher. "Endoscopic approaches to the trigeminal nerve and clinical consideration for trigeminal schwannomas: a cadaveric study." Journal of Neurosurgery 117, no. 4 (October 2012): 690–96. http://dx.doi.org/10.3171/2012.7.jns11730.

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Object The course of the trigeminal nerve straddles multiple fossae and is known to be very complex. Comprehensive anatomical knowledge and skull base techniques are required for surgical management of trigeminal schwannomas. The aims of this study were to become familiar with the endoscopic anatomy of the trigeminal nerve and to develop a minimally invasive surgical strategy for the treatment of trigeminal schwannomas. Methods Ten fresh cadavers were studied using 5 endoscopic approaches with the aid of 4-mm 0° and 30° endoscopes to identify surgical landmarks associated with the trigeminal nerve. The endoscopic approaches included 3 transcranial keyhole approaches (the extradural supraorbital, extradural subtemporal, and retrosigmoid approaches), and 2 endonasal approaches (the transpterygoid and the transmaxillary transpterygoid approaches). Results The trajectories of the extradural supraorbital, transpterygoid, and extradural subtemporal approaches corresponded with the course of the first, second, and third divisions of the trigeminal nerve, respectively. The 3 approaches demonstrated each division in intra- and extracranial spaces, as well as the Meckel cave in the middle cranial fossa. The interdural space at the lateral wall of the cavernous sinus was exposed by the extradural supraorbital and subtemporal approaches. The extradural subtemporal approach with anterior petrosectomy and the retrosigmoid approach visualized the trigeminal sensory root and its neighboring neurovascular structures in the posterior cranial fossa. The transmaxillary transpterygoid approach revealed the course of the third division in the infratemporal fossa. Conclusions The 5 endoscopic approaches effectively followed the course of the trigeminal nerve with minimal invasiveness. These approaches could provide alternative options for the management of trigeminal schwannoma.

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Sade, Burak, and Joung H. Lee. "Significance of the tentorial alignment in approaching the trigeminal nerve and the ventral petrous region through the suboccipital retrosigmoid technique." Journal of Neurosurgery 107, no. 5 (November 2007): 932–36. http://dx.doi.org/10.3171/jns-07/11/0932.

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Object In this study, the authors aimed to identify the factors that would predict the operative distance between the trigeminal nerve (fifth cranial nerve) and the acousticofacial nerve complex (seventh–eighth cranial nerves) preoperatively when approaching the cerebellopontine angle (CPA) through the suboccipital retrosigmoid approach. Methods In 40 consecutive patients who underwent microvascular decompression of the trigeminal nerve via a sub-occipital retrosigmoid approach for trigeminal neuralgia, the following three parameters were assessed on preoperative magnetic resonance images: 1) the angle between the tentorium and the line drawn from the hard palate (tentorial angle); 2) the angle between the lines drawn along the petrous bones ventral to the internal auditory canals (petrous angle); and 3) the angle between the tentorium and the line connecting the opisthion to the inion (occipital angle). The distance between the trigeminal nerve and the acousticofacial nerve complex (referred to as “distance”) was measured intraoperatively. Statistical analysis was performed using the Pearson correlation test. Results The mean values were 50.9 ± 11.5° for the tentorial angle, 102.5 ± 13.1° for the petrous angle, 83.4 ± 9.7° for the occipital angle, and 3.1 ± 1.5 mm for distance. There was a strong inverse correlation between the tentorial angle and distance (r = −0.228, p = 0.08). The mean distance was 3.5 ± 1.9 mm for a tentorial angle less than 51° and 2.7 ± 1.1 mm for a tentorial angle of at least 51°. No correlation existed between either the petrous or occipital angles and distance. Conclusions The distance between the trigeminal nerve and acousticofacial nerve complex decreases in the presence of a steep tentorial angle. This limits the operating field between these cranial nerves when reaching the petroclival or the superior CPA regions through the retrosigmoid approach. Awareness of such anatomical features at the time of pre-operative planning is of paramount importance in selecting the optimum surgical approach and minimizing operative complications.

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Davis, Karen D., and Jonathan O. Dostrovsky. "Effect of trigeminal subnucleus caudalis cold block on the cerebrovascular-evoked responses of rostral trigeminal complex neurons." Neuroscience Letters 94, no. 3 (December 1988): 303–8. http://dx.doi.org/10.1016/0304-3940(88)90035-3.

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Gushchina, M. B., A. V. Tereshchenko, D. S. Afanasyeva, E. V. Erokhina, and S. K. Demyanchenko. "A clinical case of complex treatment for paralytic lagophthalmos complicated by neurotrophic keratopathy." Modern technologies in ophtalmology, no. 6 (October 29, 2023): 52–59. http://dx.doi.org/10.25276/2312-4911-2022-6-52-59.

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Introduction. Combined leisure of facial and trigeminal nerves causes paralytic lagophthalmos and severe neurotrophic keratopathy that can lead to significant loss of vision. Material and methods. This article describes a clinical case of step-by-step complex surgical treatment in paralytic lagophthalmos accompanied by neuropathic keratopathy complicated by fistula of corneal graft. Results. The performed three stepped surgeries to improve lagophthalmos and corneal nerve supply resulted in subcompensation of lagophthalmos and restoration of corneal sensitivity up to the low limit. This was accompanied by heeling of long lasting corneal fistula. Conclusion. Pathogenetic treatment of combined paralytic changes, that includes correction of eyelid position and direct corneal neurotization, provides medical and social rehabilitation of patients with paralytic lagophthalmos complicated by neurotrophic keratopathy. Keywords: facial nerve, trigeminal nerve, neuropathic keratopathy, corneal neurotization, corneal fistula

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Banczerowski, Péter, Gábor Czigléczki, and István Nyáry. "Long-term effectiveness of an ad hoc tailored titanium implant as a spacer for microvascular decompression in the treatment of trigeminal neuralgia caused by megadolichoectatic basilar artery anomaly: 9-year follow-up." Journal of Neurosurgery 121, no. 6 (December 2014): 1492–96. http://dx.doi.org/10.3171/2014.8.jns132445.

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An enlarged, elongated, ectatic, and sclerotic aberration of the vertebrobasilar system is known as a megadolichoectatic basilar artery (BA) anomaly. The anomaly is often involved in the pathological process of trigeminal neuralgia by compressing and distorting the trigeminal nerve. First-line medical treatment includes drug therapy, but a second-line surgical procedure could be effective in medication-resistant cases. The authors report the case of a 65-year-old man with a 12-year history of progressing trigeminal neuralgia who underwent microvascular decompression after the first-line drug treatment had failed. This case is unique because an in situ tailored titanium microplate was used as a spacer to alleviate compression by the BA on the trigeminal nerve. The titanium implant provided durable and sufficient retraction for the sclerotic arterial complex when the trigeminal nerve was placed in the tunnel of the implant. The 9-year follow-up examination proves the safety and long-term efficacy of titanium implants in the treatment of trigeminal neuralgia caused by a megadolichoectatic BA anomaly. The method applied in this case was not intended to be and certainly is not an alternative to routine microvascular decompression—this surgical solution may be reserved for some extreme cases.

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Meyerson, B. A., and S. Håkanson. "Suppression of Pain in Trigeminal Neuropathy by Electric Stimulation of the Gasserian Ganglion." Neurosurgery 18, no. 1 (January 1, 1986): 59–66. http://dx.doi.org/10.1227/00006123-198601000-00010.

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Abstract Lesions of the peripheral part of the trigeminal nerve may cause trigeminal neuropathy associated with severe pain. Such pain usually does not respond to carbamazepine and analgesics, and it is continuous and lacks the characteristic paroxysmal character of tic douloureux. These patients often present with complex changes of facial sensibility in the form of dysesthesia, hyperalgesia, and allodynia. The pain sometimes responds favorably to transcutaneous nerve stimulation, but direct stimulation of the trigeminal ganglion and rootlets via an implanted electrode provides a greater likelihood of pain relief. Fourteen patients diagnosed as having painful trigeminal neuropathy received implants of a gasserian ganglion-stimulating electrode. The mean follow-up period is 4 years (range, 1 to 7 years). Eleven of the patients have retained the pain-relieving effect, and 1 had pain disappear without further stimulation. Eight of the patients estimated their pain relief to be complete or very good. There were no serious complications, but in several of the patients the electrode had to be exchanged because the insulation of the lead wires broke. For the selection of patients for permanent electrode implantation, a method has been developed for trial stimulation via a percutaneous electrode introduced into the trigeminal cistern. Temporary trial stimulation can be performed for several days. It is concluded that stimulation of the trigeminal ganglion and rootlets with the aid of an implanted electrode may effectively relieve certain forms of trigeminal pain that are otherwise extremely difficult to manage.

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Dong, Willie K., Eric H. Chudler, and Yoriko Kawakami. "Tooth pulp-evoked potentials in the trigeminal brainstem nuclear complex." Brain Research 529, no. 1-2 (October 1990): 131–42. http://dx.doi.org/10.1016/0006-8993(90)90820-2.

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Boissonade, Fiona M., Keith A. Sharkey, and Gregory E. Lucier. "Trigeminal nuclear complex of the ferret: Anatomical and Immunohistochemical studies." Journal of Comparative Neurology 329, no. 3 (March 15, 1993): 291–312. http://dx.doi.org/10.1002/cne.903290302.

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Ide, Linda S., and H. P. Killackey. "Fine structural survey of the rat's brainstem sensory trigeminal complex." Journal of Comparative Neurology 235, no. 2 (May 8, 1985): 145–68. http://dx.doi.org/10.1002/cne.902350202.

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Covell, David A., and Drew M. Noden. "Embryonic development of the chick primary trigeminal sensory-motor complex." Journal of Comparative Neurology 286, no. 4 (August 22, 1989): 488–503. http://dx.doi.org/10.1002/cne.902860407.

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Mahajan, Abhishek, Nilesh P. Sable, Richa Vaish, Aliasgar Moiyadi, Supreeta Arya, and Anil Keith D’Cruz. "Multicompartmental Trigeminal Schwannomas: Dumbbell Tumors Revisited." Journal of Global Oncology 2, no. 6 (December 2016): 431–35. http://dx.doi.org/10.1200/jgo.2016.006122.

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Multicompartmental trigeminal schwannomas (MTSs) are a rare and complex but treatable group of tumors. Herein, we describe the clinicoradiologic presentation of two patients with MTS. The two illustrated distinct case reports highlight the role of imaging and the outcome of two different types of MTS. The Discussion summarizes the literature to date, which will help the reader diagnose these tumors in a timely manner and manage them appropriately.

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Bruti, G., C. Mostardini, A. Pierallini, V. Villani, C. Modini, and R. Cerbo. "Neurovascular Headache and Occipital Neuralgia Secondary to Bleeding of Bulbocervical Cavernoma." Cephalalgia 27, no. 9 (September 2007): 1074–79. http://dx.doi.org/10.1111/j.1468-2982.2007.01363.x.

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It has recently been suggested that the trigeminocervical complex plays a crucial role in the pathophysiology of neck discomfort that accompanies migraine attacks. Clinical and neurophysiological data have shown that pain within the occipital area may be transmitted by the first trigeminal branch, which supports an anatomical and functional link between cervical and trigeminal modulation of peripheral afferents. We describe a patient with an acute symptomatic migraine attack and chronic occipital neuralgia, both due to bleeding of a bulbocervical cavernoma. The clinical presentation is also discussed and related to recent scientific data on the role of the trigeminocervical complex in both the clinical picture and underlying pathophysiological mechanisms of cervical and head pain.

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Yokota, T., N. Koyama, and N. Matsumoto. "Somatotopic distribution of trigeminal nociceptive neurons in ventrobasal complex of cat thalamus." Journal of Neurophysiology 53, no. 6 (June 1, 1985): 1387–400. http://dx.doi.org/10.1152/jn.1985.53.6.1387.

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Recordings were made from single thalamic units in the urethan-chloralose anesthetized cat. Altogether 2,905 trigeminal single units having a receptive field in the contralateral trigeminal integument were isolated from the somatosensory part of nucleus ventralis posteromedialis, or VPM proper. Each isolated unit was tested for responses to a series of mechanical stimuli. The stimuli included brushing the skin, touch, pressure, noxious pinch, and pinpricks. The majority of VPM proper units responded with the greatest discharge frequency to gentle mechanical stimulation: either hair movement or light pressure to the trigeminal integument, but 341 units were identified as trigeminal nociceptive units. They were partitioned into two functionally defined subclasses, nociceptive specific (NS) and wide dynamic range (WDR) units, but not intermingled with low-threshold mechanoreceptive (LTM) units. Both NS and WDR units were found at or near the margin of the VPM proper but not outside this nucleus. This marginal area was referred to as the shell region of the VPM proper. A total of 248 NS units was found within the shell region of the caudal third of the VPM proper. This part was called the NS zone. These units were somatotopically organized. In the rostral part of the NS zone, ophthalmic NS units having a receptive field in the contralateral ophthalmic division were located dorsolaterally, maxillary NS units occurred dorsomedially, and mandibular NS units were found ventromedially. In the caudal part of the NS zone, maxillary NS units were encountered in the dorsal shell region, whereas mandibular NS units were found in the ventromedial shell region. Ophthalmic NS units were not found in this part of the NS zone. Altogether 93 WDR units were encountered in the shell region of the VPM proper. They were confined to a narrow band approximately 300 micron wide just rostral to the NS zone. These units were somatotopically organized. Ophthalmic WDR units having a low-threshold center of the receptive field in the contralateral ophthalmic division were located dorsolaterally, maxillary WDR units were located dorsomedially, and mandibular WDR units were located ventromedially. The majority of maxillary as well as mandibular WDR units were activated by electrical stimulation of the contralateral maxillary and/or mandibular canine tooth pulp afferents. Both NS and WDR zones of the VPM proper extended into the shell region of the nucleus ventralis posterolateralis (VPL).(ABSTRACT TRUNCATED AT 400 WORDS)

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Van der Cruyssen, Frederic, and Constantinus Politis. "Neurophysiological aspects of the trigeminal sensory system: an update." Reviews in the Neurosciences 29, no. 2 (February 23, 2018): 115–23. http://dx.doi.org/10.1515/revneuro-2017-0044.

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AbstractThe trigeminal system is one of the most complex cranial nerve systems of the human body. Research on it has vastly grown in recent years and concentrated more and more on molecular mechanisms and pathophysiology, but thorough reviews on this topic are lacking, certainly on the normal physiology of the trigeminal sensory system. Here we review the current literature on neurophysiology of the trigeminal nerve from peripheral receptors up to its central projections toward the somatosensory cortex. We focus on the most recent scientific discoveries and describe historical relevant research to substantiate further. One chapter on new insights of the pathophysiology of pain at the level of the trigeminal system is added. A database search of Medline, Embase and Cochrane was conducted with the search terms ‘animal study’, ‘neurophysiology’, ‘trigeminal’, ‘oral’ and ‘sensory’. Articles were manually selected after reading the abstract and where needed the article. Reference lists also served to include relevant research articles. Fifty-six articles were included after critical appraisal. Physiological aspects on mechanoreceptors, trigeminal afferents, trigeminal ganglion and central projections are reviewed in light of reference works. Embryologic and anatomic insights are cited where needed. A brief description of pathophysiology of pain pathways in the trigeminal area and recent advances in dental stem cell research are also discussed. Neurophysiology at the level of the central nervous system is not reviewed. The current body of knowledge is mainly based on animal and cadaveric studies, but recent advancements in functional imaging and molecular neuroscience are elucidating the pathways and functioning of this mixed nerve system. Extrapolation of animal studies or functioning of peripheral nerves should be warranted.

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Culoso, Ashley, Cynthia Lowe, and Craig Evinger. "Sex, blinking, and dry eye." Journal of Neurophysiology 123, no. 2 (February 1, 2020): 831–42. http://dx.doi.org/10.1152/jn.00635.2019.

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Blinking sustains the corneal tear film generated by sexually dimorphic lacrimal and meibomian glands. Our study examines whether trigeminal control of blinking is also sexually dimorphic by investigating trigeminal reflex blinking, associative blink modification, and spontaneous blinking in male and female rats before and after unilateral dry eye caused by exorbital gland removal. Before gland removal, female rats exhibited a lower threshold for evoking trigeminal reflex blinks, a weaker effect of associative blink modification, and longer-duration spontaneous blinks than males. Spontaneous blink rate, reflex blink excitability, and occurrence of blink oscillations did not differ between the sexes. Reanalysis of previous data showed that humans showed the same blink sexual dimorphisms as rats. During the first 2 wk of dry eye, trigeminal blink circuit excitability and blink oscillations steadily rose in male rats, whereas excitability and blink oscillations did not change in females. Following dry eye, spontaneous blink duration increased for both males and females, whereas spontaneous blink rate remained constant for males but decreased for females. The associative modification treatment to depress trigeminal blink amplitude initially produced blink depression in males that converted to blink potentiation as trigeminal excitability rose, whereas females exhibited progressively more blink depression. These data indicated that dry eye increased excitability in male trigeminal reflex blink circuits at the expense of circuit modifiability, whereas trigeminal modifiability increased in females. This increased modifiability of female trigeminal blink circuits with dry eye may contribute to the preponderance of females developing the focal dystonia, benign essential blepharospasm. NEW & NOTEWORTHY All the elements controlling the corneal tear film are sexually dimorphic. Blinking, which smooths and maintains the tear film, also exhibits sex differences. Dry eye increases the sexual dimorphisms of blinking, including increased exaggeration of excitability in males and enhanced modifiability of the female trigeminal complex. This increased modifiability may explain female predominance in the development of the focal dystonia, benign essential blepharospasm.

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Kanaev, R., A. Kydyrbaeva, and Ch Niyazbekov. "Comprehensive Treatment of Patients With Classical Trigeminal Neuralgia." Bulletin of Science and Practice, no. 9 (September 15, 2023): 151–58. http://dx.doi.org/10.33619/2414-2948/94/18.

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Trigeminal neuralgia is a chronic disease characterized by short paroxysms of intense excruciating shooting pains in the innervation zone of one or more branches of the trigeminal nerve. Trigeminal neuralgia is a common disease, it occurs with a frequency of 4-5 to 30-50 cases per 100,000 population — according to reports, about 15,000 new patients are diagnosed in the United States annually. The practical social severity of trigeminal neuralgia is high — the severity of pain attacks leads to a significant disruption of the flow of the normal rhythm of life of patients. Among the conservative methods of treatment of classical trigeminal neuralgia, first-line drugs are anticonvulsants and, above all, carbamazepine, which suppresses cortical and stem foci of sensitization. In parallel with the increase in tolerance to the drug, the number of adverse events also increases. If drug therapy is ineffective, surgical methods of treatment are used. Microvascular decompression of the trigeminal nerve root is considered the “gold standard” among them. The microvascular decompression ensures the complete elimination of the pain syndrome, but the percentage of relapses of the disease varies widely. According to scientists, the relapse rate after the microvascular decompression was 28%. The mortality rate is from 0.5 to 2% and averages 1.4%. The main cause of death is a violation of blood circulation in the brain stem. In addition, damage to adjacent nerve structures occurs with varying frequency: IV, VI, VII and VIII nerves. In this regard, there was a need to develop alternative approaches to the treatment of trigeminal neuralgia with paroxysmal facial pain. The results of a clinical and instrumental study of various treatment methods are presented. The effectiveness of complex treatment for trigeminal neuralgia has been proven.

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Storer, RJ, DC Immke, R. Yin, and PJ Goadsby. "Large Conductance Calcium-Activated Potassium Channels (BKCa) Modulate Trigeminovascular Nociceptive Transmission." Cephalalgia 29, no. 12 (December 2009): 1242–58. http://dx.doi.org/10.1111/j.1468-2982.2009.01849.x.

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Migraine is a common, disabling, neurological problem whose acute management would benefit from the development of purely neurally acting therapies. The trigeminocervical complex is pivotal in nociceptive signaling in migraine, and is an accepted target for putative antimigraine agents. Whole-cell patch-clamp or extracellular recordings were made of trigeminal neurons identified in rat brainstem slices. Bath application of the large conductance calcium-activated potassium (BKCa) channel opener NS1619 caused a dramatic decrease of cell firing that could be reversed by the co-application of iberiotoxin. NS1619 hyperpolarized the resting membrane potential and reduced the frequency of spontaneous action potentials in these neurons. These data suggest the presence of BKCa channels in the trigeminocervical complex. In vivo in cat L-glutamate-evoked firing was facilitated in nociceptive neurons, also responding to stimulation of the superior sagittal sinus, in the trigeminal nucleus caudalis by the BKCa peptide antagonists, iberiotoxin and slotoxin. Of units tested, 70% responded to microiontophoretic application of the blockers, identifying a subpopulation of trigeminal neurons expressing toxin-sensitive BKCa channels. NS1619 inhibited 74% of cells tested, and this was reversed by slotoxin, suggesting that the action of NS1619 in these cells was mediated through BKCa channels. These data are consistent with the presence of BKCa channels in the trigeminal nucleus caudalis that are potential targets for the development of antimigraine treatments, and may also offer insights into receptor mechanisms involved in sensitization and thus allodynia, in migraine.

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Son, Byung-chul. "Referred Trigeminal Facial Pain from Occipital Neuralgia Occurring Much Earlier than Occipital Neuralgia." Case Reports in Neurological Medicine 2020 (August 24, 2020): 1–6. http://dx.doi.org/10.1155/2020/8834865.

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We report a very rare case in which a patient believed to have auriculotemporal neuralgia due to the repeated recurrence of paroxysmal stabbing pain in the preauricular temporal region for four years developed occipital neuralgia, which finally improved with decompression of the greater occipital nerve (GON). The pain of occipital neuralgia has been suggested to be referred to the frontoorbital (V1) region through trigeminocervical interneuronal connections in the trigeminal spinal nucleus. However, the reports of such cases are very rare. In occipital neuralgia, the pain referred to the ipsilateral facial trigeminal region reportedly also occurs in the V2 and V3 distributions in addition to that in the V1 region. In the existing cases of referred trigeminal pain from occipital neuralgia, continuous aching pain is usually induced, but in the present case, typical neuralgic pain was induced and diagnosed as idiopathic auriculotemporal neuralgia. In addition, recurrent trigeminal pain occurred for four years before the onset of occipital neuralgia. If the typical occipital neuralgia did not develop in four years, it would be impossible to infer an association with the GON. This case shows that the clinical manifestations of referred trigeminal pain caused by the sensitization of the trigeminocervical complex by chronic entrapment of the GON can be very diverse.

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Susanti, Restu. "SUNCT, A RARE TRIGEMINAL PAIN." Collaborative Medical Journal (CMJ) 3, no. 2 (July 9, 2020): 53–62. http://dx.doi.org/10.36341/cmj.v3i2.1264.

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Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) are a subset of short-lasting unilateral neuralgiform headache attacks. SUNCT is a condition that is rarely encountered and is characterized by typical moderate to severe neuralgia pain located in the first division area of the trigeminal nerve that can be felt in any part of the head. SUNCT can be primary and secondary. Typical SUNCT symptoms include severe unilateral headache with autonomic symptoms with bilateral conjunctival injection and lacrimation with an attack frequency more than 60 times per day (range 3 to 200) which can occur spontaneously or be triggered by a mechanical stimulus in an area that is innervated by the trigeminal nerve , and without a refractory period thereafter. The current treatment is still diverse, including therapy with anti-epileptic drugs, interventional therapy, or invasive procedures. The diagnosis and management of complex therapies in patients with SUNCT still need further understanding.

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Amendano, Brigette, Suzanne Spriggs, and Ian Cost. "A comparative description of the maxillary and mandibular divisions of the trigeminal nerve in birds." Journal of the Pennsylvania Academy of Science 95, no. 2 (December 1, 2021): 121–34. http://dx.doi.org/10.5325/jpennacadscie.95.2.0121.

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Abstract For many animals, touch is one of the most crucial senses, as it allows an animal to assess its surroundings, develop properly, and socialize. Remote touch is an essential part of avian survival, as it allows some families of birds to identify prey through changes in pressure. Some birds possess a sensitive bill tip organ filled with a large number of mechanoreceptors to perform remote touch sensation. This implies that they possess a complex trigeminal nerve system. The trigeminal nerve has three divisions (ophthalmic, V1; maxillary, V2; and mandibular, V3) that supply somatosensory information from the face and head. Birds from the families Apterygidae, Scolopacidae, Anatidae, Threskiornithidae, and Psittacidae are known to have a sensitive bill tip organ supplied by the trigeminal nerve, whereas other birds use vision, hearing, and other touch to identify prey, potentially resulting in less overall dependence on the trigeminal nerve. Here, we created nerve maps of birds from a range of orders including Anseriformes, Gruiformes, Pelecaniformes, Strigiformes, Accipitriformes, and Passeriformes. We find that species with a remote touch organ possess more observable nerve fiber bundles associated with the maxillary and mandibular trigeminal nerve divisions than species not possessing a remote touch organ. Our results indicate that birds with foraging or prey capture techniques not relying on mechanoreception through the bill possess maxillary and mandibular divisions of the trigeminal nerve that are less robust as they enter the beak.

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Danilov, O. D., V. I. Shepitko, O. S. Yakushko, E. V. Stetsuk, and N. V. Boruta. "MORPHOLOGICAL CHARACTERISTICS OF THE TRIGEMINAL NODE OF RATS WHEN CRYOPRESERVED PLACENTA IS INTRODUCED." Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії 22, no. 3-4 (November 29, 2022): 152–56. http://dx.doi.org/10.31718/2077-1096.22.3.4.152.

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Cryopreserved placenta preparations have a unique composition of biologically active substances, which determines their multifaceted effect. The aim of our study was to investigate the morphological features of the trigeminal node of rats when cryopreserved placenta was injected. The conducted experimental study showed that a single subcutaneous injection of cryopreserved placenta causes a reaction of the vessels of the microcirculatory bed of the trigeminal node of rats in the first two weeks of observation in the form of an expansion of the diameter of arterioles, capillaries and venules and an increase in blood filling, which indicates the stimulating effect of the components of the fetoplacental complex on the microcirculatory bed. The most pronounced phenomena were observed on the 7th day. After transplantation of the cryopreserved placenta, the neurocytes of the trigeminal node had a large, well-defined light nucleus, well-defined cytoplasm, with deep chromatophilic substance, there were dark, smaller cells with dispersed Nissl substance, satellite cells, and nerve fibers remained intact during all observation periods. The obtained data confirm the trophic effect of drugs of the fetoplacental complex. Our experimental study showed that a single subcutaneous injection of cryopreserved placenta causes a reaction of the vessels of the microcirculatory bed of the trigeminal node of rats in the first two weeks of observation in the form of an expansion of the diameter of arterioles, capillaries and venules and an increase in blood filling. The most pronounced phenomena were observed on the 7th day. The obtained data indicate the stimulating effect of the components of the fetoplacental complex on the microcirculatory channel. After transplantation of the cryopreserved placenta, neurocytes, satellite cells, and nerve fibers remained intact during all observation periods.

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47

Holland, G. R. "Experimental Trigeminal Nerve Injury." Critical Reviews in Oral Biology & Medicine 7, no. 3 (July 1996): 237–58. http://dx.doi.org/10.1177/10454411960070030301.

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The successful reinnervation of peripheral targets after injury varies with the axonal population of the nerve that is injured and the extent of the dislocation of its central component from the peripheral endoneurial tube. Larger-diameter axons such as those supplying mechanoreceptors recover more readily than narrower axons such as those supplying taste. A complex, bi-directional interaction between lingual epithelium and sprouting nerve results in the redifferentiation of taste buds after denervation. Dentin and the dental pulp provide a strong attraction to sprouting nerves and will become reinnervated from collateral sources if recovery of the original innervation is blocked. The most effective repair technique for transected lingual nerves is one which brings the cut ends together rather than one that provides a temporary bridge. Injuries can result in cell death in the trigeminal ganglion but only if the injury is severe and recovery is prevented. Lesser damage results in chromatolysis and the increased expression of neuropeptides. All nerve injuries bring about changes in the trigeminal nucleus. These occur as changes in receptive field and the incidence of spontaneously active neurons, effects which are consistent with the unmasking of existing afferents. These functional changes are short-lived and reversible. Morphologically, nerve injury results in terminal degeneration in the nuclei and an increased expression of the c-Fos gene and some neuropeptides. Only a chronic constriction injury induces behavioral changes. The adult trigeminal system retains considerable plasticity that permits it to respond successfully to nerve injury. Much remains to be learned about this response, particularly of the trophic factors that control peripheral recovery and the central response to more severe injuries.

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48

Carrasco, Carmen A., David Rojas-Salazar, Renato Chiorino, Juan C. Venega, and Nelson Wohllk. "MELANOTIC NONPSAMMOMATOUS TRIGEMINAL SCHWANNOMA AS THE FIRST MANIFESTATION OF CARNEY COMPLEX." Neurosurgery 59, no. 6 (December 1, 2006): E1334—E1335. http://dx.doi.org/10.1227/01.neu.0000245608.07570.d2.

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Abstract OBJECTIVE Melanotic schwannoma is a rare neoplasm, classifiable as a peripheral nerve sheath tumor, and differentiated from a typical schwannoma by heavy pigmentation. Psammoma bodies can be visualized in more than 50% of melanotic schwannomas. Half of patients with such “psammomatous melanotic schwannomas” have Carney complex, a dominantly transmitted autosomal disorder. Most recently, the tumor suppressor gene, PRKAR1A, coding for the Type 1α regulatory subunit of protein kinase A was found to be mutated in approximately half of the known Carney complex families. Although cranial schwannomas have been described in patients with Carney complex, their numbers are too small to be considered a definite part of the syndrome. Furthermore, only melanotic schwannomas with psammoma bodies are included as diagnostic criteria for Carney complex. The objective of this report is to communicate a case of trigeminal nonpsammomatous melanotic schwannoma as the first manifestation of Carney complex. CLINICAL PRESENTATION A 34-year-old woman presented with odontalgia, right V3hypoesthesia, V2paresthesia, and diplopia. Magnetic resonance imaging scans of the brain revealed a small tumor with homogenous contrast in the right trigeminal pathway. INTERVENTION We performed an extradural approach to the right cavernous sinus by a middle fossa approach. The lateral wall was opened between the cranial nerves, and a soft and black tumor was resected in a piecemeal fashion. Histology and immunohistochemical analysis of the tumor were compatible with melanotic schwannoma, but no psammomatous bodies were identified. Endocrine evaluation showed that this patient's symptoms fulfilled the diagnostic criteria of Carney complex, with lentiginosis, multiple breast ductal adenomas, multiple hypoechoic nodules on thyroid ultrasonography, and a 4 × 5-cm asymptomatic atrial cardiac myxoma, which was removed 15 days after the neurosurgery. Three months later, a recurrence of melanotic schwannoma was identified. Molecular analyses of genomic and somatic deoxyribonucleic acid from the patient found a 578 to 579delTG mutation of PRKAR1A. CONCLUSION We present the unusual case of a nonpsammomatous trigeminal melanotic schwannoma associated with Carney complex, with confirmed PRKAR1Agene mutation. Our case highlights that neurosurgeons, in the presence of a melanotic schwannoma, should be aware of the features of the Carney complex because, in such cases, pre- and postoperative management is significantly affected. We also postulate that the absence of psammoma bodies or cranial localization do not exclude this diagnosis.

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49

Menon, Nandita, and Anil Kishen. "Nociceptor–Macrophage Interactions in Apical Periodontitis: How Biomolecules Link Inflammation with Pain." Biomolecules 13, no. 8 (July 31, 2023): 1193. http://dx.doi.org/10.3390/biom13081193.

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Periradicular tissues have a rich supply of peripheral afferent neurons, also known as nociceptive neurons, originating from the trigeminal nerve. While their primary function is to relay pain signals to the brain, these are known to be involved in modulating innate and adaptive immunity by initiating neurogenic inflammation (NI). Studies have investigated neuroanatomy and measured the levels of biomolecules such as cytokines and neuropeptides in human saliva, gingival crevicular fluid, or blood/serum samples in apical periodontitis (AP) to validate the possible role of trigeminal nociceptors in inflammation and tissue regeneration. However, the contributions of nociceptors and the mechanisms involved in the neuro-immune interactions in AP are not fully understood. This narrative review addresses the complex biomolecular interactions of trigeminal nociceptors with macrophages, the effector cells of the innate immune system, in the clinical manifestations of AP.

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50

Bates, Carolyn A., and Herbert P. Killackey. "The organization of the neonatal rat's brainstem trigeminal complex and its role in the formation of central trigeminal patterns." Journal of Comparative Neurology 240, no. 3 (October 15, 1985): 265–87. http://dx.doi.org/10.1002/cne.902400305.

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