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Nerve coblation for treatment of Trigeminal neuralgia: A case report

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World Journal of Clinical Cases 2019年第9期7卷 1060-1065页

作者： Xiao-Hui Yang Yan Li Li-Qiang Yang Bai-Shan Wu Jia-Xiang Ni Department of Pain Medicine Capital Medical University Xuanwu Hospital Department of Pain Medicine Aerospace Central Hospital National Clinical Research Center for Geriatric Disorders

BACKGROUND Trigeminal neuralgia(TN) is a severe type of neuropathic pain which is often inadequately managed using conventional therapies. In this report, we present the first case of TN treated with gasserian ganglion nerve coblation(NC).CASE SUMMARY A 58-year-old man presented with right facial pain, mostly localized in the right zygomatic zone, alveolar region, and jaws. Similar to acupuncture and shock pain, the pain lasted about five seconds after each attack before resolving unaided. A diagnosis of TN was made, after which treatment with acupuncture therapy and oral carbamazepine was given. However, the pain was not satisfactorily controlled. Subsequently, gasserian ganglion NC of the right Trigeminal nerve guided by computed tomography(CT) was performed on the patient. Following this procedure, the right zygomatic, alveolar, submandibular,and cheek pain disappeared completely. The right zygomatic and alveolar areas experienced mild numbness(level II). At 1-, 2-, 3-, and 6-mo follow-ups after surgery, the patient was painless and the numbness score was level I.CONCLUSION CT-guided gasserian ganglion(NC) is an effective treatment for TN and is associated with less or no postoperative numbness or hypoesthesia in comparison with current standard-of-care approaches.

关键词： Nerve coblation Trigeminal neuralgia Gasserian ganglion Computed tomography guided Case report

Transcriptional profiling of dental sensory and proprioceptive Trigeminal neurons using single-cell RNA sequencing

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International Journal of Oral Science 2023年第3期15卷 513-526页

作者： Pa Reum Lee Jihoon Kim Heather Lynn Rossi Sena Chung Seung Yub Han Junhyong Kim Seog Bae Oh Department of Neurobiology and Physiology School of Dentistry and Dental Research InstituteSeoul National UniversitySeoulRepublic of Korea Genomics and Computational Biology Graduate Group University of PennsylvaniaPhiladelphiaPAUSA Department of Pathobiology University of PennsylvaniaPhiladelphiaPAUSA Department of Biology University of PennsylvaniaPhiladelphiaPAUSA Brain Science Institute Korea Institute of Science and Technology(KIST)SeoulRepublic of Korea

Dental primary afferent(DPA)neurons and proprioceptive mesencephalic Trigeminal nucleus(MTN)neurons,located in the Trigeminal ganglion and the brainstem,respectively,are essential for controlling masticatory functions.Despite extensive transcriptomic studies on various somatosensory neurons,there is still a lack of knowledge about the molecular identities of these populations due to technical challenges in their circuit-validated isolation.Here,we employed high-depth single-cell RNA sequencing(scRNA-seq)in combination with retrograde tracing in mice to identify intrinsic transcriptional features of DPA and MTN neurons.Our transcriptome analysis revealed five major types of DPA neurons with cell type-specific gene enrichment,some of which exhibit unique mechano-nociceptive properties capable of transmitting nociception in response to innocuous mechanical stimuli in the teeth.Furthermore,we discovered cellular heterogeneity within MTN neurons that potentially contribute to their responsiveness to mechanical stretch in the masseter muscle spindles.Additionally,DPA and MTN neurons represented sensory compartments with distinct molecular profiles characterized by various ion channels,receptors,neuropeptides,and mechanoreceptors.Together,our study provides new biological insights regarding the highly specialized mechanosensory functions of DPA and MTN neurons in pain and proprioception.

关键词： Trigeminal specialized Together

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Structural abnormalities of Trigeminal root with neurovascular compression revealed by high resolution diffusion tensor imaging

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Asian Pacific Journal of Tropical Medicine 2012年第9期5卷 749-752页

作者： Jing Chen Zi-Yi Guo Qi-Zhou Liang Hai-Yan Liao Wen-Rui Su Cai-Xiang Chen Shui-Xi Fu Xiang-Jun Han Radiology Department Municipal Hospital of Haikou

Objective:To detect neurovascular compression-induced structural abnormalities of Trigeminal nerves(TGN) by diffusion tensor imaging(DTI).Methods:The affected ipsilateral TGN(iTGN) and unaffected contralateral TGN(cTGN) of 20 trifacial neuralgia(TIM) patients as well as the bilateral TGN of 10 normal controls(nTGN) were examined by DTI and 3D high resolution MR] using a 3.0 T MRI scanner.The fractional anisotropy and apparent diffusion coefficieiil(ADC) were determined.Results:Compared with the cTGN and nTGN,the iTGN.had significantly lower fraction of anisotropy(FA),significantly higher ADC.and significantly smaller volume and crosssectional area(P<0.05).Conclusions:The increase in ADC and decrease in FA has a close relationship with morphological changes of TGN,and the DTI could provide valuable diagnostic information on TGN structure forTN patients.

关键词： Trigeminal nerves Diffusion tensor imaging Trifacial neuralgia Apparent diffusion coefficient Fraction of anisotropy

VGluT1- and GAD-immunoreactive terminals in synaptic contact with PAGimmunopositive neurons in principal sensory Trigeminal nucleus of rat

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Acta Pharmacologica Sinica 2007年第2期28卷 180-184页

作者： Yu-lin DONG Fu-xing ZHANG You-wang PANG Jin-lian LI~2 Department of Anatomy and K.K.Leung Brain Research Center,the Fourth Military Medical University Xi’an 710032,China DepartmentofAnatomyandK.K.LeungBrainResearchCenter theFourthMilitaryMedicalUniversityXi'an710032China

Aim:To trace the origin of abundant vesicular glutamate transporter l-like immu-noreactive(VGluT1-LI)axon terminals in the dorsal division of the principal sen-sory Trigeminal nucleus(Vpd)and the relationships between VGluT 1-LI,as well asthe glutamic acid decarboxylase(GAD)-LI axon terminals,and phosphate-activated glutaminase(PAG)-LI thalamic projecting neurons in the Vpd.Methods:Following unilateral Trigeminal rhizotoMy,triple-immunofluorescence histoche-mistry for VGluT1,GAD and PAG and the immunogold-silver method for VGluTlor GAD,combined with the immunoperoxidase method for PAG were performed,respectively.Results:After unilateral Trigeminal rhizotomy,the density of VGluTl-like immunoreactivity(IR)in the Vpd on the lesion side was reduced compared toits contralateral counterpart.Under the confocal laser-scanning microscope,theVGluT1-LI or GAD-LI axon terminals were observed to be in close apposition tothe PAG-LI thalamic projecting neuronal profiles,and further electron microscopeimmunocytochemistry confirmed that VGluTl-and GAD-LI axon terminals madeasymmetrical and symmetrical synapses upon the PAG-LI neuronal structures.Conclusion:The present results suggest that the VGluTl-LI axon terminals,whichmainly arise from the primary afferents of the Trigeminal ganglion,along with thePAG-LI neuronal profiles,form the key synaptic connection involved in sensorysignaling.

关键词： Trigeminal vesicular glutamate transporter 1 glutamic acid decarboxylase phosphateactivated glutaminase rats

Triple Puncture for Primary Trigeminal Neuralgia:A Randomized Clinical Trial

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Current Medical Science 2019年第4期39卷 638-644页

作者： Yang-pu ZHANG Yan WANG Wen-guang XIA Ai-qun SONG Department of Physical Medicine and Rehabilitation Hubei Provincial Hospital of Integrated Chinese and Western MedicineWuhan 430015China Sector of P.E. China University of GeosciencesWuhan 430074China Hubei Provincial Hospital of Traditional Chinese Medicine Wuhan 430061China Hubei Province Academy of Traditional Chinese Medicine Wuhan 430074China

To evaluate the effect of triple puncture on primary Trigeminal neuralgia (pTN),64 patients with pTN were randomly assigned to two groups:treatment group and control group.The participants in the treatment group received triple puncture treatment of 6 times per week for 4 weeks,and those in control group were given carbamazepine (300-600 mg per day) for at least 1 month.Before and after treatment,the primary outcomes including the total efficiency rate and the VAS pain scores,and the secondary outcomes including the frequency of pain attack and adverse events were observed.Sixty-two participants finished the study (33 in treatment group and 29 in control group individually).After treatment,the symptoms (mainly pain) of the two groups were alleviated.The total efficiency rate in the treatment group and control group was 90.9% and 75.9% respectively.The VAS pain scores and frequency of pain attack were significantly reduced in the treatment group as compared with the control group (P<0.05).The incidence of adverse events in the treatment group and control group was 9.1% and 24.1% respectively.It can be inferred that triple puncture can effectively improve the quality of life of patients with pTN and has less side effects.

关键词： triple puncture primary Trigeminal neuralgia randomized clinical trial

Control Pathways from the Subcortical Limbic Structures to the Trigeminal Motor System in the Lower Brainstem: A Hodological Review

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Neuroscience & Medicine 2015年第1期6卷 24-34页

作者： Yukihiko Yasui Department of Anatomy and Morphological Neuroscience Shimane University School of Medicine Izumo Japan

The organization of the emotion-related somatic motor behavior, including jaw movements, is governed not only by the cortical limbic system but also by the subcortical limbic system including the amygdala and hypothalamus. GABAergic neurons in the central amygdaloid nucleus (CeA) and glutamatergic neurons in the posterior lateral hypothalamus (PLH) exert inhibitory and excitatory influences, respectively, upon premotor neurons for the motor Trigeminal nucleus (Vm) in the parvicellular reticular formation (RFp) of the medulla oblongata. The CeA also has an inhibitory influence on non-dopaminergic (probably GABAergic) neurons in the retrorubral field of the midbrain that send their axons to the RFp. Furthermore, the CeA and lateral hypothalamus including the PLH may also modulate Vm neurons via projections to the mesencephalic Trigeminal nucleus which contains the cell bodies of primary afferent neurons conveying inputs from the masticatory muscle spindles or the periodontal ligament receptors to jaw closing motoneurons within the Vm. These pathways from the subcortical limbic structures to the Trigeminal motor system in the lower brainstem underlie the regulation of emotional jaw movements.

关键词： Amygdala Hypothalamus Motor Trigeminal Nucleus Jaw Movement Emotion

锁孔乙状窦后入路显微血管减压术治疗原发性三叉神经痛

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中华神经创伤外科电子杂志 2017年第4期3卷 255-256页

作者：郭永坤辛孟杰梁阿明姜羽贺辉辉张衍张辉郑州大学附属郑州中心医院神经外科郑州450007

一、三叉神经痛概述三叉神经痛（Trigeminal neuralgia,TN）是最常见的颅神经疾病之一,以面部三叉神经分布区出现的阵发性剧烈疼痛为主要表现的慢性疼痛疾病。目前将TN分为原发性和继发性。原发性TN是指具有临床症状,而没有发现与发病... 详细信息

一、三叉神经痛概述三叉神经痛（Trigeminal neuralgia,TN）是最常见的颅神经疾病之一,以面部三叉神经分布区出现的阵发性剧烈疼痛为主要表现的慢性疼痛疾病。目前将TN分为原发性和继发性。原发性TN是指具有临床症状,而没有发现与发病有关的器质性病变,严重影响了患者的生活、工作,甚至导致焦虑、抑郁。原发性TN的发病原因和机制仍不明确,主要有三叉神经血管压迫学说、

关键词：三叉神经痛显微血管减压术慢性疼痛 neuralgia 神经分布区颅神经疾病乙状窦后入路 Trigeminal 器质性病桥小脑角

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Continuous Inferior Alveolar Nerve Block Using an Indwelling Catheter and Inferior Maxillary Artery Embolization for the Management of Atypical Trigeminal Neuralgia

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Open Journal of Anesthesiology 2013年第9期3卷 375-378页

作者： Samer Abdel-Aziz Ahmed Ghaleb Department of Anesthesiology and Pain Medicine University of Arkansas for Medical Sciences Little Rock USA

A 40-years-old female patient with severe right facial pain with a throbbing component along the mandibular division of the Trigeminal nerve resistant to medical management. Continuous inferior alveolar nerve block with local anesthetics using an indwelling catheter provided a complete pain resolution for the patient for 2 weeks, after which the catheter got infected and was removed. A trial of balloon occlusion of the right internal maxillary artery provided complete resolution of the throbbing component of the patient’s pain. This was followed by permanent embolization with multiple coils.

关键词： Trigeminal Neuralgia Inferior Alveolar Nerve Block Inferior Maxilary Artery Embolization

Necessity of Magnetic Resonance Imaging (MRI) using an appropriate sequence for diagnosis of Trigeminal neuralgia associated with intracranial tumor

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Open Journal of Stomatology 2013年第9期3卷 510-514页

作者： Yoko Yamazaki Tomoko Niimi Yuko Ando Daisuke Tomizawa Masahiko Shimada Orofacial Pain Clinic Tokyo Medical and Dental University Dental Hos-pital Tokyo Japan Orofacial Pain Management Oral Restitution Oral Health Sciences Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan

Aims: Trigeminal neuralgia is generally caused by neurovascular compression. In rare cases intracranial tumors may also lead to this condition. The present study was conducted to identify clinical symptoms and testing methods that are useful for early detection of Trigeminal neuralgia associated with intracranial tumor. Methods: Five patients with Trigeminal neuralgia suspected to be due to intracranial tumor, who visited our department for the first time during the period between February 2007 and March 2009, were examined. We analyzed the medical records and MRI findings of these patients. The clinical symptoms of subjects were compared to those presented at the International Classification of Headache Disorders. Results: There were no feature symptoms to Trigeminal neuralgia caused by intracranial tumors compared with Trigeminal neuralgia in general. None of the patients complained of spontaneous headache and nausea, which are clinical symptoms characteristic of brain tumor. Head MRI at our hospital was the most accurate method to detect intracranial tumors. Finally four of five patients received brain surgery to remove tumors. Conclusion: Small tumors and roots of the Trigeminal nerve may not create accurate images by regular head MRI. Therefore, MRI using the imaging sequence which enables accurate visualization of roots of the Trigeminal nerve is essential to confirm the presence of tumors in patients with suspected Trigeminal neuralgia.

关键词： Trigeminal Neuralgia Intracranial Tumor Benign Tumor MRI Neurosurgery