Trigeminal neuralgia

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Trigeminal neuralgia
Other namesTic douloureux, [1] prosopalgia, [2] Fothergill's disease, [3] suicide disease [4]
Gray778.png
The trigeminal nerve and its three major divisions (shown in yellow): the ophthalmic nerve (V1), the maxillary nerve (V2), and the mandibular nerve (V3)
Specialty Neurology
Symptoms Typical: episodes of severe, sudden, shock-like pain in one side of the face that lasts for seconds to minutes [1]
Atypical: constant burning pain [1]
Complications Depression [5]
Usual onset> 50 years old [1]
TypesTypical and atypical trigeminal neuralgia [1]
CausesBelieved to be due to problems with myelin of trigeminal nerve [1] [6]
Diagnostic method Based on symptoms [1]
Differential diagnosis Postherpetic neuralgia [1]
TreatmentMedication, surgery [1]
Medication Carbamazepine, oxcarbazepine [6]
Prognosis 80% improve with initial treatment [6]
Frequency1 in 8,000 people per year [1]

Trigeminal neuralgia (TN or TGN), also called Fothergill disease, tic douloureux, trifacial neuralgia, or suicide disease, is a long-term pain disorder that affects the trigeminal nerve, [7] [1] the nerve responsible for sensation in the face and motor functions such as biting and chewing. It is a form of neuropathic pain. [8] There are two main types: typical and atypical trigeminal neuralgia. [1]

Contents

The typical form results in episodes of severe, sudden, shock-like pain in one side of the face that lasts for seconds to a few minutes. [1] Groups of these episodes can occur over a few hours. [1] The atypical form results in a constant burning pain that is less severe. [1] Episodes may be triggered by any touch to the face. [1] Both forms may occur in the same person. [1] It is regarded as one of the most painful disorders known to medicine, and often results in depression and suicide. [5]

The exact cause is unknown, but believed to involve loss of the myelin of the trigeminal nerve. [1] [6] This might occur due to nerve compression from a blood vessel as the nerve exits the brain stem, multiple sclerosis, stroke, or trauma. [1] Less common causes include a tumor or arteriovenous malformation. [1] It is a type of nerve pain. [1] Diagnosis is typically based on the symptoms, after ruling out other possible causes such as postherpetic neuralgia. [8] [1]

Treatment includes medication or surgery. [1] The anticonvulsant carbamazepine or oxcarbazepine is usually the initial treatment, and is effective in about 90% of people. [8] Side effects are frequently experienced that necessitate drug withdrawal in as many as 23% of patients. [8] Other options include lamotrigine, baclofen, gabapentin, amitriptyline and pimozide. [6] [1] Opioids are not usually effective in the typical form. [1] In those who do not improve or become resistant to other measures, a number of types of surgery may be tried. [6]

It is estimated that trigeminal neuralgia affects around 0.03% to 0.3% of people around the world with a female over-representation around a 3:1 ratio between women and men. [9] It usually begins in people over 50 years old, but can occur at any age. [1] The condition was first described in detail in 1773 by John Fothergill. [10]

Signs and symptoms

Trigeminal neuralgia Trigeminal Neuralgia.png
Trigeminal neuralgia

This disorder is characterized by episodes of severe facial pain along the trigeminal nerve divisions. The trigeminal nerve is a paired cranial nerve that has three major branches: the ophthalmic nerve (V1), the maxillary nerve (V2), and the mandibular nerve (V3). One, two, or all three branches of the nerve may be affected. Trigeminal neuralgia most commonly involves the middle branch (the maxillary nerve or V2) and lower branch (mandibular nerve or V3) of the trigeminal nerve. [11]

An individual attack usually lasts from a few seconds to several minutes or hours, but these can repeat for hours with very short intervals between attacks. In other instances, only 4–10 attacks are experienced daily. The episodes of intense pain may occur paroxysmally. To describe the pain sensation, people often describe a trigger area on the face so sensitive that touching or even air currents can trigger an episode; however, in many people, the pain is generated spontaneously without any apparent stimulation.

It affects lifestyle as it can be triggered by common activities such as eating, talking, shaving and brushing teeth. The wind, chewing, and talking can aggravate the condition in many patients. The attacks are said, by those affected, to feel like stabbing electric shocks, burning, sharp, pressing, crushing, exploding or shooting pain that becomes intractable. [8]

The pain also tends to occur in cycles with remissions lasting months or even years. Pain attacks are known to worsen in frequency or severity over time, in some people. Pain may migrate to other branches over time but in some people remains very stable. [12]

Bilateral (occurring on both sides) trigeminal neuralgia is very rare except for trigeminal neuralgia caused by multiple sclerosis (MS). This normally indicates problems with both trigeminal nerves, since one nerve serves the left side of the face and the other serves the right side. Occasional reports of bilateral trigeminal neuralgia reflect successive episodes of unilateral (only one side) pain switching the side of the face rather than pain occurring simultaneously on both sides. [13]

Rapid spreading of the pain, bilateral involvement or simultaneous participation with other major nerve trunks (such as Painful Tic Convulsif of nerves V & VII or occurrence of symptoms in the V and IX nerves) may suggest a systemic cause. Systemic causes could include multiple sclerosis or expanding cranial tumors. [14]

The severity of the pain makes it difficult to wash the face, shave, and perform good oral hygiene. The pain has a significant impact on activities of daily living especially as those affected live in fear of when they are going to get their next attack of pain and how severe it will be. It can lead to severe depression and anxiety. [15]

However, not all people will have the symptoms described above; there are variants of TN, one of which is atypical trigeminal neuralgia ("trigeminal neuralgia, type 2" or trigeminal neuralgia with concomitant pain), [16] based on a recent classification of facial pain. [17] In these instances there is also a more prolonged lower severity background pain that can be present for over 50% of the time and is described more as a burning or prickling, rather than a shock.

Trigeminal pain can also occur after an attack of herpes zoster. Post-herpetic neuralgia has the same manifestations as in other parts of the body. Herpes zoster oticus typically presents with inability to move many facial muscles, pain in the ear, taste loss on the front of the tongue, dry eyes and mouth, and a vesicular rash. Less than 1% of varicella zoster infections involve the facial nerve and result in this occurring. [18]

Trigeminal deafferentation pain (TDP), also termed anesthesia dolorosa, or colloquially as phantom face pain, is from unintentional damage to a trigeminal nerve following attempts to fix a nerve problem surgically. This pain is usually constant with a burning sensation and numbness. TDP is very difficult to treat as further surgeries are usually ineffective and possibly detrimental to the person. [19]

Causes

The trigeminal nerve is a mixed cranial nerve responsible for sensory data such as tactition (pressure), thermoception (temperature), and nociception (pain) originating from the face above the jawline; it is also responsible for the motor function of the muscles of mastication, the muscles involved in chewing but not facial expression. [20]

Several theories exist to explain the possible causes of this pain syndrome. It was once believed that the nerve was compressed in the opening from the inside to the outside of the skull; but leading research indicates that it is an enlarged or lengthened blood vessel – most commonly the superior cerebellar artery – compressing or throbbing against the microvasculature of the trigeminal nerve near its connection with the pons. [21] Such a compression can injure the nerve's protective myelin sheath and cause erratic and hyperactive functioning of the nerve. This can lead to pain attacks at the slightest stimulation of any area served by the nerve as well as hinder the nerve's ability to shut off the pain signals after the stimulation ends. This type of injury may rarely be caused by an aneurysm (an outpouching of a blood vessel); by an AVM (arteriovenous malformation); [22] by a tumor; such as an arachnoid cyst or meningioma in the cerebellopontine angle; [23] or by a traumatic event, such as a car accident. [24]

Short-term peripheral compression is often painless. [5] Persistent compression results in local demyelination with no loss of axon potential continuity. Chronic nerve entrapment results in demyelination primarily, with progressive axonal degeneration subsequently. [5] It is, "therefore widely accepted that trigeminal neuralgia is associated with demyelination of axons in the Gasserian ganglion, the dorsal root, or both." [25] It has been suggested that this compression may be related to an aberrant branch of the superior cerebellar artery that lies on the trigeminal nerve. [25] Further causes, besides an aneurysm, multiple sclerosis or cerebellopontine angle tumor, include: a posterior fossa tumor, any other expanding lesion or even brainstem diseases from strokes. [25]

Trigeminal neuralgia is found in 3–4% of people with multiple sclerosis, according to data from seven studies. [26] [27] It has been theorized that this is due to damage to the spinal trigeminal complex. [28] Trigeminal pain has a similar presentation in patients with and without MS. [29]

Postherpetic neuralgia, which occurs after shingles, may cause similar symptoms if the trigeminal nerve is damaged, called Ramsay Hunt syndrome type 2.

When there is no apparent structural cause, the syndrome is called idiopathic.

Diagnosis

Trigeminal neuralgia is diagnosed via the result of neurological and physical tests, as well as the individual's medical history. [1] Magnetic resonance angiography can be used to detect vascular compression of the trigeminal nerve and refer patients to surgery. [30]

As with many conditions without clear physical or laboratory diagnosis, TN is often misdiagnosed, and other conditions are also frequently misdiagnosed as TN. [31] [32] A person with TN may see three or four clinicians before a firm diagnosis is made. [31]

Temporomandibular disorder (TMD) can present similarly to TN, and differentiating between these conditions can be difficult. [33] Even suspected TN patients who experience brief attacks of sharp pain have had their symptoms resolve after being treated for TMD. [34] TMD pain can also be triggered by movements of the tongue or facial muscles, so TN must be differentiated from masticatory pain by differentiating between the clinical characteristics of deep somatic pain and neuropathic pain. Masticatory pain will not be arrested by a conventional mandibular local anesthetic block. [14] One quick test a dentist might perform is a conventional inferior dental local anesthetic block. If the pain is in the treated branch, the block will not arrest masticatory pain but will alleviate TN pain. [35]

Management

There is evidence that points towards the need to quickly treat and diagnose TN. It is thought that the longer a patient has TN, the harder it may be to reverse the neural pathways associated with the pain.[ citation needed ]

Medical

Surgical

Microvascular decompression provides freedom from pain in about 75% of patients presenting with drug-resistant trigeminal neuralgia. [41] [42] [43] While there may be pain relief after surgery, there is also a risk of adverse effects, such as facial numbness. Percutaneous radiofrequency thermorhizotomy may also be effective [44] as may stereotactic radiosurgery; however the effectiveness decreases with time. [45]

Surgical procedures can be separated into non-destructive and destructive:

Non-destructive

  • Microvascular decompression – this involves a small incision behind the ear and some bone removal from the area. An incision through the meninges is made to expose the nerve. Any vascular compressions of the nerve are carefully moved and a sponge-like pad is placed between the compression and nerve, stopping unwanted pulsation and allowing myelin sheath healing.[ citation needed ]

Destructive

All destructive procedures will cause facial numbness, post relief, as well as pain relief. [42]

  • Percutaneous techniques which all involve a needle or catheter entering the face up to the origin where the nerve splits into three divisions and then damaging this area, purposely, to produce numbness but also stop pain signals. These techniques are proven effective [44] especially in those where other interventions have failed or in those who are medically unfit for surgery such as the elderly.
  • Balloon compression – inflation of a balloon at this point causing damage and stopping pain signals.
  • Glycerol injection – deposition of a corrosive liquid called glycerol at this point causes damage to the nerve to hinder pain signals.
  • Radiofrequency thermocoagulation rhizotomy – application of a heated needle to damage the nerve at this point.
  • Stereotactic radiosurgery is a form of radiation therapy that focuses high-power energy on a small area of the body [46]

Support

Psychological and social support has found to play a key role in the management of chronic illnesses and chronic pain conditions, such as trigeminal neuralgia. Chronic pain can cause constant frustration to an individual as well as to those around them. [47]

History

Edvard Munch's The Scream has been used as a symbol of facial pain generally, and also specifically of trigeminal neuralgia. The Scream.jpg
Edvard Munch's The Scream has been used as a symbol of facial pain generally, and also specifically of trigeminal neuralgia.

Trigeminal neuralgia was first described by physician John Fothergill and treated surgically by John Murray Carnochan, both of whom were graduates of the University of Edinburgh Medical School. Historically TN has been called "suicide disease" due to studies by the pioneering forefather in neurosurgery Harvey Cushing involving 123 cases of TN during 1896 and 1912. In those studies it produced intense pain, higher rates of suicidal ideation in patients with severe migraines, and links to higher rates of depression, anxiety, and sleep disorders. [4] [50] [51]

Society and culture

Some individuals of note with TN include:

See also

Related Research Articles

<span class="mw-page-title-main">Ramsay Hunt syndrome type 2</span> Presentation of shingles in the geniculate ganglion

Ramsay Hunt syndrome type 2, commonly referred to simply as Ramsay Hunt syndrome (RHS) and also known as herpes zoster oticus, is inflammation of the geniculate ganglion of the facial nerve as a late consequence of varicella zoster virus (VZV). In regard to the frequency, less than 1% of varicella zoster infections involve the facial nerve and result in RHS. It is traditionally defined as a triad of ipsilateral facial paralysis, otalgia, and vesicles close to the ear and auditory canal. Due to its proximity to the vestibulocochlear nerve, the virus can spread and cause hearing loss, tinnitus, and vertigo. It is common for diagnoses to be overlooked or delayed, which can raise the likelihood of long-term consequences. It is more complicated than Bell's palsy. Therapy aims to shorten its overall length, while also providing pain relief and averting any consequences.

<span class="mw-page-title-main">Cluster headache</span> Neurological disorder

Cluster headache is a neurological disorder characterized by recurrent severe headaches on one side of the head, typically around the eye(s). There is often accompanying eye watering, nasal congestion, or swelling around the eye on the affected side. These symptoms typically last 15 minutes to 3 hours. Attacks often occur in clusters which typically last for weeks or months and occasionally more than a year.

Pudendal nerve entrapment (PNE), also known as Alcock canal syndrome, is an uncommon source of chronic pain in which the pudendal nerve is entrapped or compressed in Alcock's canal. There are several different types of PNE based on the site of entrapment anatomically. Pain is positional and is worsened by sitting. Other symptoms include genital numbness, fecal incontinence and urinary incontinence.

<span class="mw-page-title-main">Spondylosis</span> Degeneration of the vertebral column

Spondylosis is the degeneration of the vertebral column from any cause. In the more narrow sense it refers to spinal osteoarthritis, the age-related degeneration of the spinal column, which is the most common cause of spondylosis. The degenerative process in osteoarthritis chiefly affects the vertebral bodies, the neural foramina and the facet joints. If severe, it may cause pressure on the spinal cord or nerve roots with subsequent sensory or motor disturbances, such as pain, paresthesia, imbalance, and muscle weakness in the limbs.

Neuropathic pain is pain caused by a lesion or disease of the somatosensory nervous system. Neuropathic pain may be associated with abnormal sensations called dysesthesia or pain from normally non-painful stimuli (allodynia). It may have continuous and/or episodic (paroxysmal) components. The latter resemble stabbings or electric shocks. Common qualities include burning or coldness, "pins and needles" sensations, numbness and itching.

Neuralgia is pain in the distribution of a nerve or nerves, as in intercostal neuralgia, trigeminal neuralgia, and glossopharyngeal neuralgia.

<span class="mw-page-title-main">Occipital neuralgia</span> Medical condition

Occipital neuralgia (ON) is a painful condition affecting the posterior head in the distributions of the greater occipital nerve (GON), lesser occipital nerve (LON), third occipital nerve (TON), or a combination of the three. It is paroxysmal, lasting from seconds to minutes, and often consists of lancinating pain that directly results from the pathology of one of these nerves. It is paramount that physicians understand the differential diagnosis for this condition and specific diagnostic criteria. There are multiple treatment modalities, several of which have well-established efficacy in treating this condition.

Hemifacial spasm (HFS) is a rare neuromuscular disease characterized by irregular, involuntary muscle contractions (spasms) on one side (hemi-) of the face (-facial). The facial muscles are controlled by the facial nerve, which originates at the brainstem and exits the skull below the ear where it separates into five main branches.

Microvascular decompression (MVD), also known as the Jannetta procedure, is a neurosurgical procedure used to treat trigeminal neuralgia, a pain syndrome characterized by severe episodes of intense facial pain, and hemifacial spasm. The procedure is also used experimentally to treat tinnitus and vertigo caused by vascular compression on the vestibulocochlear nerve. As the goal of the Jannetta procedure is to relieve (vascular) pressure on the trigeminal nerve, it is a specific type of a nerve decompression surgery.

<span class="mw-page-title-main">Superior cerebellar artery</span> Artery of the head

The superior cerebellar artery (SCA) is an artery of the head. It arises near the end of the basilar artery. It is a branch of the basilar artery. It supplies parts of the cerebellum, the midbrain, and other nearby structures. It is the cause of trigeminal neuralgia in some patients.

Hypoesthesia or numbness is a common side effect of various medical conditions that manifests as a reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli. In everyday speech this is generally referred to as numbness.

Geniculate ganglionitis or geniculate neuralgia (GN), also called nervus intermedius neuralgia, Ramsay Hunt syndrome, or Hunt's neuralgia, is a rare disorder characterized by severe paroxysmal neuralgic pain deep in the ear, that may spread to the ear canal, outer ear, mastoid or eye regions. GN may also occur in combination with trigeminal or glossopharyngeal neuralgia.

<span class="mw-page-title-main">Signs and symptoms of multiple sclerosis</span> Neurological signs and symptoms

The signs and symptoms of multiple sclerosis (MS) encompass a wide range of neurological and physical manifestations, including vision problems, muscle weakness, coordination difficulties, and cognitive impairment, varying significantly in severity and progression among individuals.

<span class="mw-page-title-main">Atypical trigeminal neuralgia</span> Medical condition

Atypical trigeminal neuralgia (ATN), or type 2 trigeminal neuralgia, is a form of trigeminal neuralgia, a disorder of the fifth cranial nerve. This form of nerve pain is difficult to diagnose, as it is rare and the symptoms overlap with several other disorders. The symptoms can occur in addition to having migraine headache, or can be mistaken for migraine alone, or dental problems such as temporomandibular joint disorder or musculoskeletal issues. ATN can have a wide range of symptoms and the pain can fluctuate in intensity from mild aching to a crushing or burning sensation, and also to the extreme pain experienced with the more common trigeminal neuralgia.

<span class="mw-page-title-main">Nerve compression syndrome</span> Symptoms resulting from chronic, direct pressure on a peripheral nerve

Nerve compression syndrome, or compression neuropathy, or nerve entrapment syndrome, is a medical condition caused by chronic, direct pressure on a peripheral nerve. It is known colloquially as a trapped nerve, though this may also refer to nerve root compression. Its symptoms include pain, tingling, numbness and muscle weakness. The symptoms affect just one particular part of the body, depending on which nerve is affected. The diagnosis is largely clinical and can be confirmed with diagnostic nerve blocks. Occasionally imaging and electrophysiology studies aid in the diagnosis. Timely diagnosis is important as untreated chronic nerve compression may cause permanent damage. A surgical nerve decompression can relieve pressure on the nerve but cannot always reverse the physiological changes that occurred before treatment. Nerve injury by a single episode of physical trauma is in one sense an acute compression neuropathy but is not usually included under this heading, as chronic compression takes a unique pathophysiological course.

Atypical facial pain (AFP) is a type of chronic facial pain which does not fulfill any other diagnosis. There is no consensus as to a globally accepted definition, and there is even controversy as to whether the term should be continued to be used. Both the International Headache Society (IHS) and the International Association for the Study of Pain (IASP) have adopted the term persistent idiopathic facial pain (PIFP) to replace AFP. In the 2nd Edition of the International Classification of Headache Disorders (ICHD-2), PIFP is defined as "persistent facial pain that does not have the characteristics of the cranial neuralgias ... and is not attributed to another disorder." However, the term AFP continues to be used by the World Health Organization's 10th revision of the International Statistical Classification of Diseases and Related Health Problems and remains in general use by clinicians to refer to chronic facial pain that does not meet any diagnostic criteria and does not respond to most treatments.

<span class="mw-page-title-main">Orofacial pain</span> Pain of the mouth, jaws, or face

Orofacial pain (OFP) is a general term covering any pain which is felt in the mouth, jaws and the face. Orofacial pain is a common symptom, and there are many causes.

<span class="mw-page-title-main">Cervicocranial syndrome</span> Medical condition

Cervicocranial syndrome or is a combination of symptoms that are caused by an abnormality in the cervical vertebrae leading to improper function of cervical spinal nerves. Cervicocranial syndrome is either congenital or acquired. Cervicocranial syndrome may be caused by Chiari disease, Klippel-Feil malformation, osteoarthritis, and physical trauma. Treatment options include neck braces, pain medication and surgery. The quality of life for individuals suffering from Cervicocranial syndrome can improve through surgery.

<span class="mw-page-title-main">Konstantin Slavin</span>

Konstantin Slavin is a Professor and Head of the Department of Stereotactic and functional neurosurgery at the University of Illinois College of Medicine. He is a former president of the American Society for Stereotactic and functional neurosurgery and current vice-president of the World Society for Stereotactic and Functional Neurosurgery. His specialties include Aneurysm, Brain surgery, Brain Tumor, Cerebrovascular Disorders, Craniotomy, Dystonia, Essential Tremor, Facial Nerve Pain, Facial Pain, Glioblastoma, Headache disorders, Laminectomy, Lower back pain, Movement Disorders, Multiple Sclerosis, Neck Pain, Neurosurgery, Neurosurgical Procedures, Pain, Parkinson Disease, Spinal Cord Injuries, and Stroke.

A nerve decompression is a neurosurgical procedure to relieve chronic, direct pressure on a nerve to treat nerve entrapment, a pain syndrome characterized by severe chronic pain and muscle weakness. In this way a nerve decompression targets the underlying pathophysiology of the syndrome and is considered a first-line surgical treatment option for peripheral nerve pain. Despite treating the underlying cause of the disease, the symptoms may not be fully reversible as delays in diagnosis can allow permanent damage to occur to the nerve and surrounding microvasculature. Traditionally only nerves accessible with open surgery have been good candidates, however innovations in laparoscopy and nerve-sparing techniques made nearly all nerves in the body good candidates, as surgical access is no longer a barrier.

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 "Trigeminal Neuralgia Fact Sheet". NINDS. National Institutes of Health. 17 March 2020. Retrieved 5 April 2021.
  2. ↑ Hackley CE (1869). A text-book of practical medicine. D. Appleton & Co. p.  292 . Retrieved 2011-08-01. prosopalgia.
  3. ↑ Bagheri SC, Farhidvash F, Perciaccante VJ (December 2004). "Diagnosis and treatment of patients with trigeminal neuralgia". Journal of the American Dental Association. 135 (12): 1713–1717. doi:10.14219/jada.archive.2004.0124. PMID   15646605. Archived from the original on July 11, 2012. Retrieved 2011-08-01.
  4. 1 2 Adams H, Pendleton C, Latimer K, Cohen-Gadol AA, Carson BS, Quinones-Hinojosa A (May 2011). "Harvey Cushing's case series of trigeminal neuralgia at the Johns Hopkins Hospital: a surgeon's quest to advance the treatment of the 'suicide disease'". Acta Neurochirurgica. 153 (5): 1043–1050. doi:10.1007/s00701-011-0975-8. PMID   21409517. S2CID   28245294.
  5. 1 2 3 4 Okeson JP (2005). "6". In Lindsay Harmon (ed.). Bell's orofacial pains: the clinical management of orofacial pain. Quintessence Publishing Co, Inc. p. 114. ISBN   0-86715-439-X. Archived from the original on 2014-01-12.
  6. 1 2 3 4 5 6 Obermann M (March 2010). "Treatment options in trigeminal neuralgia". Therapeutic Advances in Neurological Disorders. 3 (2): 107–115. doi:10.1177/1756285609359317. PMC   3002644 . PMID   21179603.
  7. ↑ "Trigeminal Neuralgia". National Organization for Rare Disorders, Inc. 26 February 2014.
  8. 1 2 3 4 5 Cruccu G, Di Stefano G, Truini A (August 2020). Ropper AH (ed.). "Trigeminal Neuralgia". The New England Journal of Medicine. 383 (8): 754–762. doi:10.1056/NEJMra1914484. PMID   32813951. S2CID   221201036.
  9. ↑ Araya EI, Claudino RF, Piovesan EJ, Chichorro JG (2020-01-23). "Trigeminal Neuralgia: Basic and Clinical Aspects". Current Neuropharmacology. 18 (2): 109–119. doi:10.2174/1570159X17666191010094350. PMC   7324879 . PMID   31608834.
  10. ↑ Prasad S, Galetta S (March 2009). "Trigeminal neuralgia: historical notes and current concepts". The Neurologist. 15 (2): 87–94. doi:10.1097/nrl.0b013e3181775ac3. PMID   19276786. S2CID   23500191.
  11. ↑ "Trigeminal Neuralgia and Hemifacial Spasm" (PDF). UF Health Shands Hospital. November 2012. Retrieved 5 April 2021.
  12. ↑ Bayer DB, Stenger TG (November 1979). "Trigeminal neuralgia: an overview". Oral Surgery, Oral Medicine, and Oral Pathology. 48 (5): 393–399. doi:10.1016/0030-4220(79)90064-1. PMID   226915.
  13. ↑ Cruccu G, Finnerup NB, Jensen TS, Scholz J, Sindou M, Svensson P, et al. (July 2016). "Trigeminal neuralgia: New classification and diagnostic grading for practice and research". Neurology. 87 (2): 220–228. doi:10.1212/WNL.0000000000002840. PMC   4940067 . PMID   27306631.
  14. 1 2 Okeson JP (2005). "17". In Lindsay Harmon (ed.). Bell's orofacial pains: the clinical management of orofacial pain. Quintessence Publishing Co, Inc. p. 453. ISBN   0-86715-439-X. Archived from the original on 2014-01-12.
  15. ↑ Smith JG, Elias LA, Yilmaz Z, Barker S, Shah K, Shah S, et al. (2013). "The psychosocial and affective burden of posttraumatic neuropathy following injuries to the trigeminal nerve". Journal of Orofacial Pain. 27 (4): 293–303. doi: 10.11607/jop.1056 . PMID   24171179.
  16. ↑ "Neurological surgery: facial pain". Oregon Health & Science University. Archived from the original on June 25, 2004. Retrieved 2011-08-01.
  17. ↑ Burchiel KJ (November 2003). "A new classification for facial pain". Neurosurgery. 53 (5): 1164–7. doi:10.1227/01.NEU.0000088806.11659.D8. PMID   14580284. S2CID   33538452.
  18. ↑ Feller L, Khammissa RA, Fourie J, Bouckaert M, Lemmer J (2017). "Postherpetic Neuralgia and Trigeminal Neuralgia". Pain Research and Treatment. 2017: 1681765. doi: 10.1155/2017/1681765 . PMC   5735631 . PMID   29359044.
  19. ↑ "Anesthesia Dolorosa". The Facial Pain Association. 14 April 2021.
  20. ↑ Pazhaniappan N (15 August 2020). "The Trigeminal Nerve (CN V)". TeachMeAnatomy. Retrieved 5 April 2021.
  21. ↑ Nurmikko TJ, Eldridge PR (July 2001). "Trigeminal neuralgia--pathophysiology, diagnosis and current treatment". British Journal of Anaesthesia. 87 (1): 117–132. doi: 10.1093/bja/87.1.117 . PMID   11460800.
  22. ↑ Singh N, Bharatha A, O'Kelly C, Wallace MC, Goldstein W, Willinsky RA, et al. (September 2010). "Intrinsic arteriovenous malformation of the trigeminal nerve". The Canadian Journal of Neurological Sciences. Le Journal Canadien des Sciences Neurologiques. 37 (5): 681–683. doi: 10.1017/S0317167100010891 . PMID   21059518.
  23. ↑ Babu R, Murali R (June 1991). "Arachnoid cyst of the cerebellopontine angle manifesting as contralateral trigeminal neuralgia: case report". Neurosurgery. 28 (6): 886–887. doi:10.1097/00006123-199106000-00018. PMID   2067614.
  24. ↑ Croft SM, Foreman AC (2002). Whiplash injuries : the cervical acceleration/deceleration syndrome (3rd ed.). Baltimore: Williams & Wilkins. p. 481. ISBN   978-0-7817-2681-8. Archived from the original on 2017-03-14.
  25. 1 2 3 Okeson JP (2005). "6". In Lindsay Harmon (ed.). Bell's orofacial pains: the clinical management of orofacial pain. Quintessence Publishing Co, Inc. p. 115. ISBN   0-86715-439-X. Archived from the original on 2014-01-12.
  26. ↑ Foley PL, Vesterinen HM, Laird BJ, Sena ES, Colvin LA, Chandran S, et al. (May 2013). "Prevalence and natural history of pain in adults with multiple sclerosis: systematic review and meta-analysis". Pain. 154 (5): 632–642. doi:10.1016/j.pain.2012.12.002. PMID   23318126. S2CID   25807525.
  27. ↑ De Santi L, Annunziata P (February 2012). "Symptomatic cranial neuralgias in multiple sclerosis: clinical features and treatment". Clinical Neurology and Neurosurgery. 114 (2): 101–107. doi:10.1016/j.clineuro.2011.10.044. PMID   22130044. S2CID   3402581.
  28. ↑ Cruccu G, Biasiotta A, Di Rezze S, Fiorelli M, Galeotti F, Innocenti P, et al. (June 2009). "Trigeminal neuralgia and pain related to multiple sclerosis". Pain. 143 (3): 186–191. doi:10.1016/j.pain.2008.12.026. hdl:11573/361397. PMID   19171430. S2CID   24353039.
  29. ↑ De Simone R, Marano E, Brescia Morra V, Ranieri A, Ripa P, Esposito M, et al. (May 2005). "A clinical comparison of trigeminal neuralgic pain in patients with and without underlying multiple sclerosis". Neurological Sciences. 26 (S2): s150–s151. doi:10.1007/s10072-005-0431-8. PMID   15926016. S2CID   23024675.
  30. ↑ Bora N, Parihar P, Raj N, Shetty N, Nunna B (September 2023). "A Systematic Review of the Role of Magnetic Resonance Imaging in the Diagnosis and Detection of Neurovascular Conflict in Patients With Trigeminal Neuralgia". Cureus. 15 (9): e44614. doi: 10.7759/cureus.44614 . PMC   10547583 . PMID   37799230.
  31. 1 2 Antonaci F, Arceri S, Rakusa M, Mitsikostas DD, Milanov I, Todorov V, et al. (June 2020). "Pitfals in recognition and management of trigeminal neuralgia". The Journal of Headache and Pain. 21 (1): 82. doi: 10.1186/s10194-020-01149-8 . PMC   7325374 . PMID   32605593.
  32. ↑ Slettebø H (October 2021). "Is this really trigeminal neuralgia? Diagnostic re-evaluation of patients referred for neurosurgery". Scandinavian Journal of Pain. 21 (4): 788–793. doi: 10.1515/sjpain-2021-0045 . PMID   34333890.
  33. ↑ Drangsholt M, Truelove EL (2001). "Trigeminal neuralgia mistaken as temporomandibular disorder". Journal of Evidence Based Dental Practice. 1 (1): 41–50. doi:10.1067/med.2001.116846.
  34. ↑ Ceneviz C, Maloney G, Mehta N (July 2006). "Myofascial pain may mimic trigeminal neuralgia". Cephalalgia. 26 (7): 899–901. doi:10.1111/j.1468-2982.2006.01123.x. PMID   16776712.
  35. ↑ Cherian A, Maroju NK (9 December 2020). Raghavendra M (ed.). "Trigeminal Nerve Block". MedScape. Archived from the original on 26 October 2015. Retrieved 20 November 2015.
  36. ↑ Sindrup SH, Jensen TS (2002). "Pharmacotherapy of trigeminal neuralgia". The Clinical Journal of Pain. 18 (1): 22–27. doi:10.1097/00002508-200201000-00004. PMID   11803299. S2CID   24407923.
  37. ↑ Ahmed OL, Akinyele OA, Akindayo OA, Bamidele K, et al. (September 2012). "Management of Trigeminal Neuralgia using Amitriptyline and Pregablin combination Therapy". African Journal of Biomedical Research. 15 (1): 201–203. Archived from the original on 2016-08-22.
  38. ↑ Hsu CC, Chang CW, Peng CH, Liang CS (August 2014). "Rapid Management of Trigeminal Neuralgia and Comorbid Major Depressive Disorder With Duloxetine". The Annals of Pharmacotherapy. 48 (8): 1090–1092. doi:10.1177/1060028014532789. PMID   24788987. S2CID   38592913.
  39. ↑ Lunn MP, Hughes RA, Wiffen PJ (January 2014). "Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia". The Cochrane Database of Systematic Reviews. 2014 (1): CD007115. doi:10.1002/14651858.CD007115.pub3. PMC   10711341 . PMID   24385423.
  40. ↑ Zakrzewska JM, Linskey ME (February 2014). "Trigeminal neuralgia" (PDF). BMJ. 348 (feb17 9): g474. doi:10.1136/bmj.g474. PMID   24534115. S2CID   45305211. Archived (PDF) from the original on 20 December 2016.
  41. ↑ Holste K, Chan AY, Rolston JD, Englot DJ (February 2020). "Pain Outcomes Following Microvascular Decompression for Drug-Resistant Trigeminal Neuralgia: A Systematic Review and Meta-Analysis". Neurosurgery. 86 (2): 182–190. doi:10.1093/neuros/nyz075. PMC   8253302 . PMID   30892607.
  42. 1 2 Zakrzewska JM, Akram H (September 2011). "Neurosurgical interventions for the treatment of classical trigeminal neuralgia". The Cochrane Database of Systematic Reviews. 2011 (9): CD007312. doi:10.1002/14651858.CD007312.pub2. PMC   8981212 . PMID   21901707.
  43. ↑ Barbor M (5 October 2015). "MVD Bests Gamma Knife for Pain in Trigeminal Neuralgia". Archived from the original on 2015-11-10.
  44. 1 2 Sindou M, Tatli M (April 2009). "[Treatment of trigeminal neuralgia with thermorhizotomy]". Neuro-Chirurgie. 55 (2): 203–210. doi:10.1016/j.neuchi.2009.01.015. PMID   19303114.
  45. ↑ Dhople AA, Adams JR, Maggio WW, Naqvi SA, Regine WF, Kwok Y (August 2009). "Long-term outcomes of Gamma Knife radiosurgery for classic trigeminal neuralgia: implications of treatment and critical review of the literature. Clinical article". Journal of Neurosurgery. 111 (2): 351–358. doi:10.3171/2009.2.JNS08977. PMID   19326987.
  46. ↑ Yi-Bin C. "Stereotactic radiosurgery – Cyber Knife". MedLine Plus. Archived from the original on 21 November 2015. Retrieved 20 November 2015.
  47. ↑ Molitor N. "Dr". American Psychological Association. Archived from the original on 26 June 2015. Retrieved 27 June 2015.
  48. ↑ Williams CG, Dellon AL, Rosson GD (May 2009). "Management of chronic facial pain". Craniomaxillofacial Trauma & Reconstruction. 2 (2): 67–76. doi:10.1055/s-0029-1202593. PMC   3052669 . PMID   22110799.
  49. ↑ "Facial Neuralgia Resources". Trigeminal Neuralgia Resources / Facial Neuralgia Resources. Archived from the original on 8 July 2013. Retrieved 8 May 2013.
  50. ↑ "Why Trigeminal Neuralgia is Considered the "Suicide Disease"". Arizona Pain Specialists LLC. 26 September 2021.
  51. ↑ Prasad S, Galetta S (March 2009). "Trigeminal neuralgia: historical notes and current concepts". The Neurologist. 15 (2): 87–94. doi:10.1097/NRL.0b013e3181775ac3. PMID   19276786. S2CID   23500191.
  52. ↑ Sack JJ (December 2014). "William Gladstone: New Studies and Perspectives. Edited by Roland Quinault, Roger Swift, and Ruth Clayton Windscheffel.Farnham: Ashgate, 2012. Pp. xviii+350. $134.95". The Journal of Modern History. 86 (4): 904–905. doi:10.1086/678722.
  53. ↑ "Melissa Seymour: My perfect life is over". Womansday.ninemsn.com.au. 2009-06-18. Archived from the original on 2009-12-14. Retrieved 2013-10-09.
  54. ↑ "Salman suffering from the suicide disease". www.hindustantimes.com. Hindustan Times. 2011-08-24. Archived from the original on 2014-07-15. Retrieved 2014-06-18.
  55. ↑ Foley A (16 September 2014). "Serious illness meant Christy Toye didn't play in 2013 but now he's set for All-Ireland final: The Donegal player has experienced a remarkable revival". The Score. Archived from the original on 4 October 2014. Retrieved 16 September 2014.
  56. ↑ "MP urges greater awareness of trigeminal neuralgia". BBC – Democracy Live. BBC. 2010-07-27. Archived from the original on 21 November 2015. Retrieved 20 November 2015.
  57. ↑ "U.S. Senate: Jefferson Davis' Farewell". Archived from the original on 2011-03-01. Retrieved 2011-06-09.
  58. ↑ Brent J (1993). Charles Sanders Peirce: A Life. Bloomington: Indiana University Press. pp. 39–40.
  59. ↑ Gorney C (November–December 1995). "Gloria". Mother Jones. Archived from the original on July 29, 2016. Retrieved July 1, 2016.
  60. ↑ "Anneli van Rooyen's road to recovery". News24. 2011-08-26. Archived from the original on 2017-03-05. Retrieved 2016-09-12.
  61. ↑ Guardian Music (2017-02-03). "Hardcore legend HR of Bad Brains to undergo brain surgery". The Guardian. Archived from the original on 2017-03-02. Retrieved 2017-03-02.
  62. ↑ "The latest news from TNA UK". 2020-06-01. Retrieved 2020-09-23.[ permanent dead link ]
  63. ↑ "Blink 182 Drummer Travis Barker Uses CBD to Treat Rare Condition: "I Love CBD"". vaporvanity. February 5, 2019. Retrieved 2021-02-11.
  64. ↑ Voska M, Goth J (25 August 2024). "Zemřel herec Karel Heřmánek, na střelnici obrátil zbraň proti sobě". iDNES.cz (in Czech). Mafra . Retrieved 25 August 2024.
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