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Anticonvulsant drugs for acute and chronic pain.

BACKGROUND: Anticonvulsant drugs have been used in the management of pain since the 1960s. The clinical impression is that they are useful f … algesic effect of sodium valproate. Three placebo-controlled studies of carbamazepine in trigeminal neuralgia had a combined NNT (95% confidence interval (CI)) for effectiveness of 2.5 (CI 2.0-3.4). A single placebo-controlled trial of gabapentin in post-herpetic neuralgia had an NNT of 3.2 (CI 2.4-5.0). For diabetic neuropathy NNTs for effectiveness were a …

Intrapelvic Nerve Entrapment Syndrome Caused by a Variation of the Intrapelvic Piriformis Muscle and Abnormal Varicose Vessels: A Case Report.

Entrapment neuropathy of the sciatic nerve and pudendal nerve are painful syndromes that are often overlooked by physicians. Laparoscopic surgical interventions for nerve entrapment syndromes of the posterior pelvis focus on removing the compression lesion with the purpose of eliminating the suspected cause of sciatica, as well as pudendal neuralgia. Herein, the authors report the rare event of sciatic and pudendal nerve entrapment, which was caused by aberrant vessels and a variant piriformis muscle bundle, as a seldom-diagnosed cause of sciatica and pelvic pain, for both neurosurgeons and ne…

Rimegepant: First Approval.

The orally disintegrating tablet (ODT) formulation of rimegepant (NURTEC ODT®) is a small molecule, highly-selective, calcitonin gene-related peptide antagonist that was developed by Biohaven Pharmaceutical Holding Company Ltd as an acute treatment for migraine. A conventional tablet formulation of the drug is being investigated for the acute treatment (under FDA review in the USA) and prevention of migraine and the treatment of refractory trigeminal neuralgia. In February 2020, rimegepant ODT received its first global approval in the USA for the acute treatment of migraine (± aura) in adults.…

Варичелла зостерный менингит: нетипичный случай возрождения зостеров у молодых людей, обладающих иммунокомпетентностью.

Вирус Варичеллы — нейротропический вирус, который может возродиться позже в жизни, чтобы вызвать зостер или шиворот. Как правило, она затрагивает пожилых людей, иммунокомпромиссных людей. Мы сообщаем о необычайном случае, когда молодой человек, обладающий иммунокомпетентностью, страдает затылочной головной болью и зостерной сыпью, без предгерпетической и постгерпетической нейронгии, у которого был диагностирован варицелла менингит на цепной реакции полимеразы (ПХД). Его лечили внутривенным ацикловиром, а затем выписали на фамчикловире. Диагноз варицелла менингита затруднен в отсутствие типичны

Совпадение в аннотации оригинала
Varicella virus is a neurotropic virus that can reactivate later in life to cause zoster or shingles. Typically, it affects elderly, immunocompromised population. We report an unusual case of an immunocompetent young adult presenting with occipital headache and zoster rash, without preherpetic and postherpetic neuralgia, who was diagnosed with varicella meni…

[Serving for the longevity and health of people, being the teacher with righteousness and charity: professor XIA Shouren, the acupuncture master in modern times].

Professor XIA Shouren is a famous acupuncture master in China and has devoted his life to clinical practice, teaching and scientific study of TCM. In his 50 years of medical career, he has studied Chinese and western medicine, innovated ancient masters' experiences, adhered to the theory of "less but highly-effective needling", specified at genjie points and deeply explored the specificity of acupoints. Additionally, the acupuncture stfudy has been firstly conducted in the diagnosis and treatment of trigeminal neuralgia in China and his own unique academic thought has been formed. Professor XI…

Interferon beta-associated recurrence of painful trigeminal neuropathy attributed to a multiple sclerosis plaque.

We report the case of a 49-year-old woman with painful trigeminal neuropathy in the right maxillary division attributed to a multiple sclero … d. Our case suggests that treatment with interferon beta may also exacerbate symptomatic trigeminal neuralgia in multiple sclerosis.

Somatotopic organization of trigeminal ganglion: three-dimensional reconstruction of three divisions.

Clearing the somatotopic organization of trigeminal ganglion can help us to improve the precision of treatment for trigeminal neuralgia. The distribution of primary afferent perikarya of 3 branches of trigeminal nerve in the trigeminal ganglion was investigated in the rabbit, and 3D model was reconstructed then. After application of wheat germ agglutinin-horseradish peroxidase and DiI to the cut endings of the 3 branches of trigeminal nerve, ophthalmic cells were found in the anteromedial part of the trigeminal ganglion, mandibular cells in the posterolateral part, and maxillary cells in the m…

Numbness over the distribution of trigeminal nerve--trigeminal trophic syndrome or viral neuritis: a diagnostic dilemma!

Numbness and ulceration of the face, particularly erosion of ala of the nose, sometimes occur after sensory denervation in the territory of the divisions of the trigeminal nerve. The incidence is uncertain and usually follows surgical treatments for trigeminal neuralgia. Such condition is known as trigeminal trophic syndrome (TTS), although some authors believe it to be a special form of dermatitis artefacta. Trigeminal trophic syndrome most commonly affects adults, after iatrogenic, vascular, viral, or neoplastic damage to the trigeminal nerve. We present a rare case of TTS in a 32-year-old w…

Peritonsillar abscess: is there any evidence of lateralized distribution? An analysis of 294 patients.

OBJECTIVE: Generally, peritonsillar abscess (PTA) occurs only on one side. Diseases of paired organs show a distinct asymmetry of occurrence: for instance gynaecomastia, varicocele, trigeminal neuralgia, carcinoma of the breast and carcinoma of the ethmoid sinus. Therefore, the goal of the present study was to investigate a possible dominance of one side in PTA. MATERIAL AND METHOD: Lateralization of a PTA was studied in 294 patients treated at Radebeul Hospital between January 2004 and December 2009. RESULT: We found only a slight predominance of the left side in male as well as female pati…

Johan Georg Raeder (1889-1959) and paratrigeminal sympathetic paresis.

INTRODUCTION: Johan Georg Raeder (1889-1959) was the most eminent Norwegian ophthalmologist in the early decades of the last century. Raeder made significant contributions to our current understanding of glaucoma. He is remembered for a syndrome he described, that of trigeminal nerve neuralgia and/or paresis and incomplete Horner's syndrome (oculopupillary sympathetic paresis). DISCUSSION: Here, Raeder's biography, scientific contributions, and a thorough review of his original report on paratrigeminal sympathetic paresis are presented. Raeder's syndrome may reflect a lesion of the middle cra…

Dynamic mechanical allodynia in neuropathic pain.

Thirty-four patients with various forms of neuropathic pain have been examined with respect to two parameters of dynamic mechanical allodynia: the effect of repetitive stimulation on pain intensity; and refractory period. Pain intensity increased with repetitive stimulation ('windup') in most patients with neuropathic pain of peripheral origin, while it was not observed in patients with central neuropathic pain. While a non-responsive period occurs after tactile allodynic elicitation in patients with trigeminal neuralgia (Kugelberg and Lindblom, 1959), it was not seen in any case of neuropathi…

[The neurotrophic ulcer of the N. trigeminus].

Trigeminal trophic ulceration is a rare clinical entity after an injury to the sensitive root of the trigeminal nerve, mostly due to therapy for trigeminal neuralgia. Other rare causes are Wallenberg's syndrome or a history of removal of acoustic neuroma. After weeks to years, a slowly progressive ulceration develops due to autonomic dysfunction and the patient manipulation because of serious chronic paresthesia. Finally, in many cases, a significant defect of the nasal arch develops. In spite of typical clinical signs and location, diagnosis is made late in most cases. Reviewing the literatur…

Safety and efficacy of oxcarbazepine: results of randomized, double-blind trials.

Oxcarbazepine is approved as monotherapy and adjunctive therapy for partial seizures with and without secondarily generalized seizures in ad … y therapeutic failure design trials in patients with refractory partial seizures, and in trigeminal neuralgia and affective disorder. The results of oxcarbazepine in treating epilepsy are discussed.

[Sunct syndrome: case report and literature review].

The case of a woman with short neuralgiform paroxysmal attacks located in orbital-periorbital area and associated with autonomic features of ten years duration is reported. This headache syndrome is compared with trigeminal neuralgia involving the first branch of the nerve. Duration, intensity, spreading of the pain and presence of accompanying ipsilateral vasomotor phenomena may be of help in the differential diagnosis. According to the latest reports, sex distribution which passed from 17 men/2 women to 18/6 and effect of the carbamazepine on pain would not appear to have an effect. Neverthe…

Primary malignant schwannoma involving simultaneously the right Gasserian ganglion and the distal part of the right mandibular nerve. Case report.

A 66-year-old man presented to our Department with trigeminal neuralgia of the third division of the right trigeminal nerve. He also complained of some difficulty in mastication because of a tumour mass in the right lower jaw. A brain CT scan, X-rays of the lower jaw and viscerocranium CT scan revealed a malignant schwannoma of the right Gasserian ganglion involving simultaneously the distal end of the right mandibular nerve. The patient was operated on and has undergone a course of external irradiation. Seven years later, he is living a normal life. The value of the preoperative diagnosis of …

Lumbar radiofrequency sympatholysis.

PURPOSE: The purpose of this article is to present a modified technique for lumbar radiofrequency sympatholysis and to compare the results with chemical sympatholysis. METHODS: Eight patients underwent the percutaneous procedure on an outpatient basis. Sympatholysis was produced with a radiofrequency lesion generator according to distinct anatomic criteria. RESULTS: Six of eight patients met previously used criteria for sympatholysis 8 weeks after the procedure. Postsympatholytic neuralgia occurred transiently in 50% of patients. CONCLUSIONS: The technique produces sympatholysis comparable …

[Painful syndromes connected with disseminated sclerosis].

Multiple sclerosis (MS) is frequently regarded as a painless condition. A review of the literature reveals that approximately 2/3 of the patients with multiple sclerosis will experience painful syndromes during the course of disease and that these are associated with the disease. Acute syndromes are described: Trigeminal neuralgia, Lhermitte's sign, optic neuritis and tonic seizure. Chronic syndromes: Dysaesthesia, pain in extremities, muscular spasms, low back pain and headache. The frequency, causes and suggestions for treatment are mentioned. A Danish investigation has revealed that only 42…

Measurement of tissue impedance in dorsal root entry zone surgery for pain after brachial plexus avulsion and herpes zoster.

Fifteen patients with brachial plexus avulsion and five patients with postherpetic pain underwent dorsal root entry zone surgery with intraoperative impedance monitoring. The usual range of initial impedance values recorded in the superficial layers of the normal cord is from 1,000 to 1,500 omega. The recordings usually decrease to less than 1,000 omega in the segments of root avulsion injuries. Some variation in recordings occurs owing to atrophy and scarring of the damaged cord. In postherpetic neuralgia, measurements of impedance are abnormally low in the involved area, in which the roots a…

[Intraoperative brainstem auditory evoked potential in the microvascular decompression of the 5th and 7th cranial nerves].

Microvascular decompression techniques are rational surgical procedures for treating trigeminal neuralgia and facial hemispasm, with results ranging from good to excellent in 90% of cases. Among the most frequent complications recorded in the literature concerning these decompressions, impairment of the facial nerve and auditory nerve account for 5% to 10% due to mechanical traction and/or vascular injury. The peroperative use of early brain-stem evoked potentials (BAEP) was performed on 17 patients in a series of 325 decompressions of the trigeminal nerve, and on 17 patients in a series of 25…