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[The role of platybasia in trigeminal neuralgia].

INTRODUCTION: The vascular compression of a nerve is known to be the most important cause of idiopathic trigeminal neuralgia (ITN) by most authors. However, several cases of skull base deformities in patients with ITN have been reported in our bibliographic review. AIM. To compare the existence of platybasia between a group of patients with ITN and a randomized control group. SUBJECTS AND METHODS: Twenty-five patients with ITN and twenty-five control subjects were X-rayed and their basal angles were measured and compared. RESULTS: The basal angle measured to investigate the existence of plat…

An update on the treatment of postherpetic neuralgia.

UNLABELLED: Like other types of neuropathic pain, postherpetic neuralgia (PHN) can be resistant to many types of pharmacologic and interventional therapies. Although many analgesic agents have been used for the treatment of other types of neuropathic pain, tricyclic antidepressants, antiepileptic drugs, opioids, and lidocaine patch appear to demonstrate relative analgesic efficacy for the treatment of pain from PHN. There are fewer studies on the use of interventional options for the treatment of pain from PHN. The majority of interventional therapies show equivocal analgesic efficacy although…

Postherpetic neuralgia in an elderly patient.

A 67-year-old patient presented to the community pharmacy with poorly controlled postherpetic neuralgia (PHN) pain following an episode of herpes zoster. The clinical pharmacist did a medication review and found that, although the patient was receiving medications proven effective in the treatment of PHN, she was not receiving optimal therapy. Additionally, the patient was experiencing intolerable side effects. The pharmacist provided recommendations to the patient's primary care physician that ultimately improved the patient's pain control. Managing PHN pain requires practitioners to be vigil…

Tolerability of treatments for postherpetic neuralgia.

Herpes zoster occurs in up to 20% of people infected with varicella-zoster virus, due to reactivation of the virus from latently infected sensory ganglia. Although pain is a typical feature of acute zoster, pain persisting for more than a month after resolution of the rash is less common and is termed postherpetic neuralgia (PHN). The pain associated with PHN is neuropathic in origin and is notoriously difficult to treat. The incidence of herpes zoster and its associated complications both increase with age, so PHN should be seen more commonly in an aging population. Vaccination with live, att…

Лечение и профилактика постгерпетической нейронгии.

В последнее время было достигнуто 4 крупных успеха в лечении постгерпетической нейронгии (PHN), которые основаны на результатах выборочных, контролируемых испытаний. Эти достижения - демонстрация того, что габапентин, лидокаин 5% и опиоидная анальгетика являются эффективными у пациентов с ПХН, а также сообщение о том, что нортриптилин и амитриптилин обеспечивают эквивалентные анальгетические выгоды для пациентов с ПХН, но что нортриптилин более терпим. Результаты этих клинических испытаний кратко рассматриваются, и обсуждаются их последствия для лечения пациентов с ПХН. Несмотря на эти успехи

Совпадение в аннотации оригинала
There have been 4 recent major advances in the treatment of postherpetic neuralgia (PHN) that are based on the results of randomized, controlled trials. These advances are the demonstrations that gabapentin, the lidocaine patch 5%, and opioid analgesics are efficacious in patients with PHN, and the report that nortriptyline and amitriptyline provide equivale…

Managing the comorbidities of postherpetic neuralgia.

PURPOSE: To discuss the impact of pain and its associated comorbidities in elderly patients with postherpetic neuralgia (PHN). To review the pharmacologic treatments available for patients with chronic pain and concurrent sleep disturbance, depression, and/or anxiety. DATA SOURCES: Relevant clinical literature pertaining to the management of common comorbid conditions in patients with PHN and chronic pain syndromes. CONCLUSIONS: Chronic pain strongly influences physical and psychological function in elderly patients. Comorbid illnesses, such as insomnia, depression, or anxiety, often develop…

[Neurosurgical therapy of facial neuralgias].

INTRODUCTION: Neuralgias of the face, especially trigeminal neuralgia and glossopharyngeal neuralgia are indications for surgical interventions after failed medical therapy. In contrast to other forms of headache or atypical facial pain, where surgical measures are considered to be contraindicated, percutaneous procedures or microvascular decompression are able to produce immediate and longstanding pain relief. Careful preoperative evaluation is essential to confirm the clinical diagnosis and to rule out other causes as multiple sclerosis or tumors afflicting the cranial nerves. The following …

On the natural history of trigeminal neuralgia.

OBJECTIVE: Trigeminal neuralgia is usually considered a separate entity from atypical trigeminal neuralgia. The exact relationship among these two and several other syndromes of facial pain remains unknown. There is no long-term prospective study of the natural history of trigeminal neuralgia nor any explanation for the existence of different, albeit somewhat similar, facial pain syndromes. DESCRIPTION OF CONCEPT: On the basis of our clinical experience, we propose a theory that may explain different facial pain syndromes as sequential stages of the same disease process. Typical trigeminal ne…

Treatment of postherpetic neuralgia: an update.

Postherpetic neuralgia (PHN) is a chronic pain syndrome that is often refractory to treatment and can last for years, causing physical and social disability, psychological distress, and increased use of the healthcare system. In this paper we provide an update on recent developments in the treatment of PHN. We emphasise the results of recent studies that provide an evidence-based approach for treating PHN that was not available until very recently. In randomised, controlled clinical trials, the topical lidocaine patch, gabapentin, and controlled release oxycodone have been shown to provide sup…

Radiosurgery for trigeminal neuralgia and epilepsy.

The role of Gamma Knife surgery in the field of functional surgery recently has evolved dramatically. For treatment of trigeminal neuralgia, Gamma Knife surgery is the least invasive procedure, with a low rate of hypesthesia. If a rate of complete relief similar to that of other surgical techniques could be achieved, this approach will become one of the main techniques used to treat the disease initially. The authors present their experience with a group of 16 patients with mesial temporal lobe epilepsy who have been treated successfully (15 completely seizure-free and 1 with rare, nondisablin…

[Glycine in the treatment of trigeminal neuralgia].

As many as 98 patients suffering from trigeminal neuralgia were given myeglynol (glycine) in a dose of 110 mg/kg a day for 4-5 weeks. A noticeable effect manifesting in the counteracting painful paroxysms was attained in more than 86% of cases. The drug was administered alone at the disease onset. The treatment effect of myeglynol may be related to its capacity to decrease to normal the high concentration of formaldehyde in the blood serum of patients suffering from trigeminal neuralgia.

[Treatment for trigeminal neuralgia. An overview].

In the past few years the following methods have been accepted as the treatment of choice in trigeminal neuralgia: transcutaneous electrical nerve stimulation (TENS), drug treatment--especially carbamazepine, controlled thermocoagulation, percutaneous retrogasserian rhizotomy with glycerol, microvascular decompression. The attending physician will prefer the treatment from which he expects the best results. However,the choice of treatment should take into consideration the age and general condition of the patient, the possible side effects, the quality of pain and treatments already performed.

Mechanisms of syncope in glossopharyngeal neuralgia.

Syncope is a rare presentation of glossopharyngeal neuralgia (GN). The mechanisms of the syncope were studied in a patient with recurrent episodes comprising prolonged cardiac standstill and arterial hypotension. During attacks, no supraventricular or ventricular potentials were recorded in the ECG. Atropine prevented the cardiac arrest without affecting the pain, indicating the vagus as the efferent limb of the reflex asystole. Following atropine blood pressure continued to fall during GN attacks, suggesting abolition of sympathetic tone. Indeed, serum norepinephrine levels fell during these …