Long-term outcomes of Gamma Knife radiosurgery for trigeminal neuralgia patients with or without concomitant continuous pain.

The effectiveness of Gamma Knife radiosurgery (GKRS) in treating trigeminal neuralgia (TN) has been demonstrated by a number of previous studies. However, there is a lack of research specifically documenting the initial and long-term outcomes of paroxysmal and persistent pain respectively following GKRS for TN with concomitant continuous pain (CCP). This study retrospectively analyzed pain outcomes and complications in 46 TN patients with CCP and 112 patients without CCP who underwent GKRS as initial surgical intervention at our institution from January 2019 to January 2024.

A functional unbalance of TRPM8 and Kv1 channels underlies orofacial cold allodynia induced by peripheral nerve damage.

Cold allodynia is a debilitating symptom of orofacial neuropathic pain resulting from trigeminal nerve damage. The molecular and neural bases of this sensory alteration are still poorly understood. Here, using chronic constriction injury (CCI) of the infraorbital nerve (IoN) (IoN-CCI) in mice, combined with behavioral analysis, Ca imaging and patch-clamp recordings of retrogradely labeled IoN neurons in culture, immunohistochemistry, and adeno-associated viral (AAV) vector-based delivery , we explored the mechanisms underlying the altered orofacial cold sensitivity resulting from axonal damage in this trigeminal branch.

[Surgical treatment of secondary trigeminal neuralgia].

Objective: To present a case series analysis of surgical treatment of patients with secondary trigeminal neuralgia.

Material And Methods: The treatment of 8 patients with secondary trigeminal neuralgia who underwent surgery since 2021 was analyzed. All records, neuroimaging archive, and follow-up observations were reviewed.

Prognostic Effect of Trigeminal Neuralgia Treated With Percutaneous Balloon Compression by Machine Learning-based Modeling of Radiomic Morphological Features.

Background: Trigeminal neuralgia (TN) is defined as spontaneous pain in the region of the trigeminal nerve that seriously affects a patient's quality of life. Percutaneous balloon compression of the trigeminal ganglion is a simple and reproducible surgical procedure that reduces the incidence of TN, but the postoperative outcome is poor in some patients, with it being ineffective or TN recurring.

Objectives: To establish a machine learning-based clinical imaging nomogram to predict the recurrence of trigeminal neuralgia in patients treated with percutaneous balloon compression.

Bibliometric analysis of research developments in oral and maxillofacial neuralgia from 2004 to 2023.

This study employs bibliometric techniques to dynamically represent the research landscape of oral and maxillofacial neuralgia. Its goal is to pinpoint research hotspots and delineate forthcoming trends. A systematic search of the Web of Science Core Collection was performed using targeted keywords to retrieve literature from January 2004 to December 2023.

Intranasal Treatment with Cannabinoid 2 Receptor Agonist HU-308 Ameliorates Cold Sensitivity in Mice with Traumatic Trigeminal Neuropathic Pain.

Post-traumatic trigeminal neuropathy (PTTN) is a sensory abnormality caused by injury to the trigeminal nerve during orofacial surgery. However, existing analgesics are ineffective against PTTN. Abnormal microglial activation in the caudal part of the spinal trigeminal nucleus caudal part (Sp5C), where the central trigeminal nerve terminals reside, plays an important role in PTTN pathogenesis.

Evaluation of the Mandibular Function Impairment Questionnaire in Clinical Diagnosis of Temporomandibular Joint Disorder.

Introduction: The Mandibular Function Impairment Questionnaire (MFIQ) was developed for clinical assessment of functional impairment in patients with temporomandibular disorder (TMD). It allows patients to rank difficulty performing 17 jaw-related functions as low, moderate or severe. Our study was designed to determine whether the MFIQ is also helpful in differentiating TMD from other causes of orofacial pain in a clinical setting.

Minocycline ameliorates cognitive impairment in rats with trigeminal neuralgia by regulating microglial polarization.

Trigeminal neuralgia (TN)-related cognitive impairment is a common cause of decreased quality of life in patients and is closely associated with neuroinflammation. Although minocycline has demonstrated anti-inflammatory, analgesic, and neuroprotective functions, its role in treating TN-related cognitive impairment remains unreported. In this study, we used an in vivo TN model and an in vitro model of primary microglial neuroinflammation to investigate the potential effects of minocycline on cognitive function and microglial polarization in TN rats.

Pathophysiology and Management of Refractory Trigeminal Neuralgia.

Purpose Of Review: Discuss the current understanding of the pathophysiology and management of refractory trigeminal neuralgia (TN). This includes a discussion on why TN can recur after microvascular decompression and a discussion on "outside of the box" options when both first- and second-line management strategies have been exhausted.

Recent Findings: This review discusses second- and third-line oral medication options, botulinum toxin A, repeat microvascular decompression, repeat ablative procedures, internal neurolysis, trigeminal branch blockade, and neuromodulation using TMS or peripheral stimulation.

Causal relationship between hypothyroidism and peripheral neuropathy: a Mendelian randomization study of European ancestry.

Background: Metabolic disorders are significant risk factors for peripheral neuropathy (PN) diseases. However, current clinical observational studies cannot fully determine the causal relationships between hypothyroidism (HT) and PN diseases.

Methods: We performed univariate Mendelian randomization (MR) analyses using single nucleotide polymorphisms (SNPs) associated with hypothyroidism and two diseases clinically presented as HT (autoimmune thyroid disease and benign neoplasm of the pituitary gland and craniopharyngeal duct) as instrumental variables.

Altered intra- and inter-network functional activity among migraine, chronic migraine, and trigeminal neuralgia.

Objective: This study aimed to investigate the specific manifestations and differences in brain network activity and functional connectivity between brain networks in patients with trigeminal neuralgia and migraine, aiming to reveal the neural basis of these two diseases.

Background: Head and facial pain, including trigeminal neuralgia and migraine, is prevalent globally. However, the underlying neural mechanisms of these conditions remain unclear.

Effect of autophagy blockage on trigeminal neuropathic pain in rats: Role of microglia.

Microglia activation and autophagy changes are associated with the regulation of pain, but no study to date has been designed to address whether these features apply to trigeminal neuropathic pain. This study aimed to investigate how alterations in autophagy affect nociceptive behaviors may be associated with microglia activation in the caudal part of the spinal trigeminal nucleus (SpVC) in a rat model of trigeminal neuropathic pain. This model was established by chronic constriction injury of the infraorbital nerve.

The Quadrant Localization Technique for Percutaneous Balloon Compression Surgery is Beneficial for Patients with Classic Trigeminal Neuralgia: A Retrospective Study.

Background: The Hartel anterior approach is a commonly used puncture method in percutaneous balloon compression (PBC) surgery. However, anatomical variations along the puncture path, and visual errors on x-ray 2-dimensional imaging, may increase the difficulty of a successful first attempt. Our clinical practice has shown that employing the quadrant localization technique to plan puncture points and angles can enhance the puncture success rate.

Microvascular decompression in trigeminal neuralgia using a robot-assisted exoscope and head-mounted display.

Objective: Microvascular decompression (MVD) in trigeminal neuralgia (TN) is currently managed using an operating microscope (OM). Recent experiences with endoscopy-assisted, fully endoscopic, and exoscopic surgery have been described, aiming to improve ergonomics and image quality. The aim of this study was to report the first series of patients operated on with the aid of a robotic binocular exoscope using a head-mounted display (RoboticScope).

Predictive value of MRI for identifying symptomatic neurovascular compressions in classical trigeminal neuralgia: a PRISMA-compliant meta-analysis.

Background: Patients with trigeminal neuralgia frequently undergo magnetic resonance imaging (MRI) prior to surgery. In patients without the signs and symptoms of face discomfort, MRI has shown the presence of neurovascular contact (NVC) in humans. Therefore, its capacity to accurately exclude NVC of the trigeminal nerve is not properly understood.

Direct prion neuroinvasion following inhalation into the nasal cavity.

Inhalation of prions into the nasal cavity is an efficient route of infection. Following inhalation of infectious prions, animals develop disease with a similar incubation period compared with per os exposure, but with greater efficiency. To identify the reason for this increased efficiency, we identified neural structures that uniquely innervate the nasal cavity and neural structures known to mediate neuroinvasion following oral infection and used immunohistochemistry to determine the temporal and spatial accumulation of prions from hamster tissue sections containing cell bodies and axons at 2-week intervals following prion exposure.

Retreatment predictors after percutaneous balloon gangliolysis for trigeminal neuralgia.

Percutaneous balloon ganglyolysis (PBG) for trigeminal neuralgia (TN) is an inexpensive and minimally invasive treatment modality that is effective and safe. While there are reports of its efficacy, there is still a lack of evidence of which patients are at a higher risk of treatment failures and needing retreatment. We performed a retrospective study at a major academic institution from 2012 to 2023, including TN patients who underwent PBG procedures to evaluate predictors of retreatment.

Anterior selective targeting for radiosurgical treatment of trigeminal neuralgia: a cohort study.

Objective: Before commonly used targets such as the Retrogasserian Zone (RGZ) and the Root Entry Zone (REZ) were adopted for the radiosurgical treatment of trigeminal neuralgia (TN), a more anterior target involving the Gasserian ganglion was used. Thanks to advancements in imaging technology, it is now possible to identify and target separate nerve divisions in Meckel's Cave as desired. Although this approach has been mentioned previously, no clinical study has investigated it until now.

Harnessing polysialic acid (PSA)-embedded exudate-absorbing hydrogel for on-demand trigeminal neuralgia treatment.

A key characteristic of trigeminal neuralgia (TN) is cytokine-enriched exudate and a "reactive oxygen species (ROS) storm" generated from the inflammatory cascade, resulting in demyelination of the sensory root of the trigeminal nerve, tissue swelling, and intense electric shock-like pain. The clinically approved drug carbamazepine (CBZ) is capable of inhibiting pain, reducing inflammatory factors, and alleviating oxidative stress, but its clinical application is restricted by its systemic toxicity. Herein, we developed an exudate-absorbing hydrogel incorporating polysialic acid (PSA) and CBZ (F127@PSA@CBZ) for on-demand TN treatment.

Radiation exposure and safety in low-dose CT-guided glycerol rhizotomy for trigeminal Neuralgia outside the operating room.

Background: Percutaneous rhizotomy of the Gasserian ganglion is a well-established intervention for patients suffering from refractory trigeminal pain, not amenable to pharmacological management or microvascular decompression. Traditionally conducted under fluoroscopic guidance using Hartel's technique, this study investigates a modified approach employing low-dose CT guidance to achieve maximal procedural precision and safety with the emphasis on minimizing radiation exposure.

Methods: A retrospective analysis of patients undergoing percutaneous rhizotomy of the Gasserian ganglion at our institution was undertaken.

Complications Following Microvascular Decompression (MVD) for Trigeminal Neuralgia (TN).

This article descibes the surgical management of classic trigeminal neuralgia via microvascular decompression of the neuro-vascular conflict zone. This treatment has been proven to be higly effective with an immediate relief of debilitating symptoms and a durable response. The article reports on cases with associated complications and their avoidance.