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Meta-analysis and sequential analysis of acupuncture compared to carbamazepine in the treatment of trigeminal neuralgia

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World Journal of Clinical Cases 2024年第22期12卷 5083-5093页

作者： Li Wei Hui Han Jie Meng Xin Li Qing-Ping Yao Department of Encephalopathy Tianjin Beichen Traditional Chinese Medicine HospitalTianjin 300400China Department of Acupuncture First Teaching Hospital of Tianjin University of Traditional Chinese MedicineTianjin 300193China Bio-engineering Institute Tianjin Modern Vocational Technology CollegeTianjin 300350China

BACKGROUND In this randomized controlled trial(RCT)comparing current acupuncture with carbamazepine for trigeminal neuralgia,meta-and sequential analyses were *** To guide clinical decision making regarding the treatment of trigeminal neuralgia with *** The RCT literature on needle comparison was searched in various Chinese biomedical databases including Chinese Biomedical Literature Database,Wanfang Data,VIP Database,as well as international databases such as Excerpt Medica Database,Cochrane Library,PubMed,and Web of Science,along with related clinical registration platforms such as World Health Organization International Clinical Trial Registry Platform,ChiCTR,and Clinical Trials up to 1 April *** of bias was evaluated using the Cochrane Collaborative Risk Bias tool,primary outcome measures(pain reduction)were analyzed using STATA metaanalysis,outcome measures were analyzed using trial sequential analysis 0.***.5.10 Beta sequential analysis,GRADE was used to assess the evidence,and adverse reactions were *** This study analyzed 16 RCTs with a total of 1231 *** meta-analysis revealed a statistically significant difference in pain reduction between acupuncture and carbamazepine[standardized mean difference(SMD)=1.47;95%confidence interval(CI):0.99-1.95],although the quality of evidence was deemed to be of extremely low *** meta-analysis based on the year of publication indicated that carbamazepine treatment first demonstrated a statistically significant difference in pain reduction in 2014 and remained relatively stable over time[SMD=1.84;95%CI:0.22-3.47].Additionally,the number of adverse events associated with acupuncture was significantly lower compared to *** Acupuncture for trigeminal neuralgia is better than analgesia and safer than carbamazepine;however,firm conclusions still require a high-quality,multicenter,large-sample RCT to confirm these findings.

关键词： trigeminal neuralgia Acupuncture Carbamazepine Meta-analysis Randomized controlled trial

Fully endoscopic far-lateral supracerebellar infratentorial approach for trigeminal neuralgia: illustrative case reports

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中华神经外科杂志(英文) 2024年第2期10卷 1-5页

作者： Yao Hong Yang Wenlei Tang Hao Cheng Yijun Lin Shaojian Wu Zhe Bao Department of Neurosurgery Center of Pituitary Tumor Ruijin Hospital Shanghai Jiao Tong University School of Medicine# Ruijin Er Road Shanghai China

Background trigeminal neuralgia (TN) is a common cause of craniofacial pain. The retrosigmoid approach is usually used to treat TN, but no cases of endoscopic far-lateral supracerebellar infratentorial approach (EF-SCITA) were used to undergo operation for *** presentation Two patients were presented with severe facial pain and preliminary diagnosis was TN. Preoperative magnetic resonance imaging revealed that a superior cerebellar artery (SCA) compressed the trigeminal nerve in case 1, and a tumor located in the petrous apex extending into the Meckel’s cave compressed the trigeminal nerve in case 2. Operations were achieved through the EF-SCITA. The pain was totally relieved with no postsurgical complications in both *** We present the first two case reports of EF-SCITA to relieve classical and secondary TN successfully. The EF-SCITA can be a promising approach for treating TN.

关键词： Approach Endoscopic surgery trigeminal neuralgia

Differences in individual susceptibility affect the development of trigeminal neuralgia

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Neural Regeneration Research 2013年第14期8卷 1337-1342页

作者： Yusuf Kurtulus Duransoy Mesut Mete Emrah Akay Mehmet Seluki Department of Neurosurgery Celal Bayar University School of Medicine Clinic of Neurosurgery Anamur State Hospital

trigeminal neuralgia is a syndrome due to dysfunctional hyperactivity of the trigeminal nerve, and is characterized by a sudden, usually unilateral, recurrent lancinating pain arising from one or more divisions of the nerve. The most accepted pathogenetic mechanism for trigeminal neuralgia is compression of the nerve at its dorsal root entry zone or in its distal course. In this paper, we report four cases with trigeminal neuralgia due to an unknown mechanism after an intracranial intervention The onset of trigeminal neuralgia after surgical interventions that are unrelated to the trigeminal nerve suggests that in patients with greater individual susceptibility, nerve contact with the vascular structure due to postoperative pressure and changes in cerebrospinal fluid flow may cause the onset of pain.

关键词： neural regeneration peripheral nerve injury asymptomatic vascular compression of the cranialnerves cranial nerves dorsal root entry zone dorsal root exit zone etiology hyperactivedysfunction syndrome individual susceptibility risk factors trigeminal neuralgia neuroregeneration

Percutaneous Radiofrequency Thermocoagulation for the Treatment of Different Types of trigeminal neuralgia:Evaluation of Quality of Life and Outcomes

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2010年第3期30卷 403-407页

作者：黄轶忠倪家骧武百山何明伟杨力强王琦 Department of Pain Therapeutic Center Xuanwu HospitalCapital Medical University

Radiofrequency thermocoagulation(RFT) of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia(CTN).In this study we compared its efficacy in patients with CTN and atypically symptomatic or mixed trigeminal neuralgia(MTN).Fifty-seven patients were treated with RFT for trigeminal neuralgia from June 2006 to February *** patients had CTN,and 27 had *** were measured by using the visual analog pain scale(VAS) and patients’ reports of quality of life(QOL),medication usage,and complications over a follow-up period of up to 3 *** results showed that the patients with MTN were younger,tended to have bilaterial involvement of the first division,and were unresponsive to *** surgeries were completed *** 86.7% CTN patients and 48.1% MTN patients responded immediately to *** VAS scores were significantly higher in the CTN group than in MTN group(P<0.05).Kaplan-Meier curves showed that 1-year,2-year,and 3-year pain relief rates were 76.7%,73.3%,and 73.3% in the CTN group and 46.6%,41.4%,and 41.4% in the MTN group,*** rates of pain relief for both groups leveled off at 2 *** included numbness,dysesthesia,and anesthesia *** did not cause any deaths and complications were *** treatment was very effective for CTN and,to some degrees,effective for *** numbness,dysesthesia,and anesthesia dolorosa are limited to the trigger area,QOL will be greatly improved.

关键词： facial pain trigeminal neuralgia classical trigeminal neuralgia mixed trigeminal neuralgia quality of life

Analgesic Effect of Diprospan in Rats with trigeminal neuralgia

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2011年第3期31卷 395-399页

作者：王延秀李晓光曹灵敏田玉科 Department of Anesthesiology Tongji HospitalTongji Medical CollegeHuazhong University of Science and Technology Department of Anesthesiology Tai'an Central Hospital Department of Stomatology Tai'an Central Hospital

This study examined the analgesic effect of diprospan in rats with trigeminal *** model of trigeminal neuralgic pain was established by loosely ligating the left infraorbital branch of the trigeminal *** allodynia developed,the rats were randomly divided into 2 groups（n=20 in each）：diprospan group,in which the rats received diprospan（7 mg/mL,0.1 mL） injected to the left infraorbital foramen area;control group,in which saline（0.1 mL） was administered as the same manner as the diprospan *** pain threshold（PT） in the left infraorbital area was measured before and 2,6,and 8 weeks after the *** expression of neuropeptides [substance P,preprotachykinin A（PPTA）,calcitonin gene-related peptide（CGRP）] in the trigeminal nerve was detected at the same time points as the PT measurement by immunohistochemistry or in situ hybridization *** results showed that in the diprospan group,the PT was 10.65±1.26,10.77±1.19 and 14.13±1.34 g 2,6,and 8 weeks after the administration respectively,significantly higher than that before the administration（PT value：0.36±0.11）（P0.05 for each）.In the saline group,the PT was 0.37±0.13,0.66±0.09,4.45±1.29 and 13.72±1.72 g before and 2,6,and 8 weeks after the administration respectively with differences being significant between before and 6,8 weeks after the administration（P0.01）.No significant difference existed in the PT between the diprospan group and the saline group at pre-administration（P0.05）.The PT in the diprospan group was significantly greater than that in the saline group 2 and 6 weeks post-administration（P0.05）.In the diprospan group,the expression levels of neuropeptides were significantly reduced as compared with those in the saline group 2 and 6 weeks post-administration（P0.05）.It was concluded that diprospan has an obvious analgesic effect on the trigeminal neuropathic pain partly by reducing the expression of neuropeptides in the trigeminal ganglia.

关键词： diprospan betamethasone trigeminal neuralgia pain threshold substance P calcitonin gene-related peptide

Oxcarbazepine for trigeminal neuralgia may induce lower extremity weakness: A case report

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World Journal of Clinical Cases 2020年第5期8卷 922-927页

作者： Hyun-Gul Song Francis Sahngun Nahm Department of Anesthesiology and Pain Medicine Seoul Metropolitan Government-Seoul National University Boramae Medical CenterSeoul 07061South Korea Department of Anesthesiology and Pain Medicine Seoul National University Bundang HospitalSeongnam 13620South Korea

BACKGROUND Although few studies have reported hyponatremia due to carbamazepine or oxcarbazepine in patients with epilepsy,no study has investigated cases of carbamazepine-or oxcarbazepine-induced hyponatremia or unsteady gait in patients with neuropathic ***,we report a case of oxcarbazepineinduced lower leg weakness in a patient with trigeminal neuralgia and summarize the diagnosis,treatment,and changes of clinical *** SUMMARY A 78-year-old male with a history of lumbar spinal stenosis was admitted to the hospital after he experienced lancinating pain around his right cheek,eyes,and lip,and was diagnosed with trigeminal neuralgia at the right maxillary and mandibular *** was prescribed oxcarbazepine(600 mg/d),milnacipran(25 mg/d),and oxycodone/naloxone(20 mg/10 mg/d)for four *** years later,the patient experienced symptoms associated with spinal stenosis,including pain in the lower extremities and unsteady *** serum sodium level was 127 mmol/*** oxcarbazepine to be the cause of the hyponatremia,oxcarbazepine administration was put on hold and the patient was switched to *** subsequent visit,the patient’s serum sodium level had normalized to 143 mmol/L and his unsteady gait had *** Oxcarbazepine-induced hyponatremia may cause lower extremity weakness and unsteady gait,which should be differentiated from those caused by spinal stenosis.

关键词： Case report Drug-related side effects and adverse reactions Hyponatremia Oxcarbazepine Spinal stenosis trigeminal neuralgia

THREE-DIMENSIONAL COMPUTED TOMOGRAPHY-GUIDED RADIOFREQUENCY trigeminal RHIZOTOMY FOR TREATMENT OF IDIOPATHIC trigeminal neuralgia

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Chinese Medical Sciences Journal 2005年第3期20卷 206-209页

作者： Meng Liu Cheng-yuan Wu Yu-guang Liu Hong-wei Wang Fan-gangMeng Department of Neurosurgery Qilu Hospital Shandong University Jinan 250012

Objective To evaluate the effectiveness of three-dimensional computed tomography （3D-CT） guided radiofi＇equency trigeminal rhizotomy （RF-TR） in treatment of idiopathic trigeminal neuralgia （1TN）. Methods From 1999 to 2001, 18 patients with ITN were treated with percutaneous controlled RF-TR. Intraoperative 3D-CT scanning was performed to guide the trajectory of the puncture. After correction of the needle tip according to the CT scans and stimulation effects, 2 to 5 lesions were made for a duration of 60-90 seconds at a temperature of 60℃ to 75℃ depending on the pain distribution and the age of patient. The needles located in foramen ovale. Pain alleviated immediately with no serious complication in all patients. The patients were followed up for an average of 31.5 months （range 24-41 months）. Acute pain relief was experienced by 17 patients after the procedure, reaching an initial success rate of 94.4%. Early （〈 6 months） pain recurrence was observed in 2 patients （11.1%）, whereas late （〉 6 months） recurrence was reported in 3 patients （16.7%）. Thirteen patients had complete pain control, with no need for medication thereafter. Five cases experienced partial pain relief, but required medication at a lower dose than in the preoperative period. Conclusion 3D-CT foramen ovale locations can raise the successful rate of puncture, enhance the safety, and reduce the incidence rate of complication.

关键词： trigeminal neuralgia radiofrequency trigeminal rhizotomy three-dimensional computed tomograhpy

Therapeutic Effects of the Point-injection Therapy on Primary trigeminal neuralgia An Observation of 103 Cases

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Journal of Traditional Chinese Medicine 2003年第3期23卷 195-196页

作者：林矛王新中 Maoming Municipal Hospital of Traditional Chinese Medicine Maoming 525000Guangdong Province

From 1996 to 1999, the author treated 103 cases of primary trigeminal neuralgia by point-injection with lidocaine, VB1 and VB12, and obtained quite good therapeutic results. A report follows.

关键词： Acupuncture Points Acupuncture Therapy Adult Aged Female Follow-Up Studies Humans Injections Lidocaine Male Middle Aged Recurrence Thiamine trigeminal neuralgia Vitamin B 12

Study on the Relation Between MRI Findings and Acupuncture Effect in trigeminal neuralgia Patients

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Journal of Acupuncture and Tuina Science 2013年第1期11卷 36-41页

作者： Bao Hong Li Jing Zhu Le-qun Yuan Jun Xu Kai-wen Han Chou-ping Department of Medical Imaging Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine Department of Acupuncture & Moxibustion Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine

Objective： To observe the relationship between acupuncture and MRI （Magnetic Resonance Imaging） findings in patients with trigeminal neuralgia （TN）. Methods： A total of 32 idiopathic TN patients who completed acupuncture treatment protocol were recruited in this trial. The relationship between acupuncture effect and MRI findings were analyzed by using MRI-B-FFE （Balanced Fast Field Echo） technique to record MRI information, such as the distance from the brainstem to the contact point of offending vessels and trigeminal nerve, the contact angle of offending vessels and trigeminal nerve, and the ratio of the diameter of the contact vessel to trigeminal nerve width. Results： After acupuncture treatment, 9 cases got marked effect, 19 got improvement, and 4 got no effect. Acupuncture effect was neither associated with the distance from the brainstem to the contact point of the offending vessel and trigeminai nerve （P〉0.05） nor the ratio of the diameter of the offending vessel to trigeminal nerve width （P〉0.05）; however, it was indeed associated with the running course of the offending vessels （P〈0.05）. Conclusion： The bigger the angle between the offending vessels and trigeminal nerve, the poorer the acupuncture effect. The B-FFE technique can be used for screening acupuncture-indicated TN patients.

关键词： trigeminal neuralgia Magnetic Resonance Imaging AcupunctureAnalgesia Acupuncture-moxibustion Therapy Warm Needling Therapy