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Ronald Brisman

B ilateral trigeminal neuralgia has been reported to occur infrequently. This disorder is difficult to treat because of the unpleasant sequelae of bilateral denervation. The present report demonstrates a higher incidence of bilateral involvement than in other series (32 cases or 11.9%) in a group of 269 patients with trigeminal neuralgia. Percutaneous radio-frequency electrocoagulation (RFE) of the retrogasserian rootlets and gasserian ganglion, either alone or with glycerol, proved to be an excellent therapeutic technique. Summary of Cases Patient

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Familial trigeminal neuralgia

Case report and review of the literature

Ian G. Fleetwood, A. Micheil Innes, Susan R. Hansen and Gary K. Steinberg

female/male ratio was 1.6:1. The right side of the face was more commonly affected, by a factor of 1.6. Trigeminal neuralgia was present in approximately 2.2 generations per family. The distribution of TN symptomatology was as follows: in 45% of patients symptoms were confined to the maxillary distribution of the nerve, in 14% symptoms were confined to the mandibular branch, and in 27% there was involvement of both of these branches. In the remainder there was involvement of the ophthalmic nerve division only (7%), the first two divisions (2.5%), or all three divisions

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Microvascular decompression for trigeminal neuralgia

Results with special reference to the late recurrence rate

Robert Breeze and Ronald J. Ignelzi

M icrovascular decompression of the trigeminal nerve at its root entry zone is one of the methods currently available for the treatment of trigeminal neuralgia. Its value, risks, and limitations have been defined, but many of the reports to date have a relatively short follow-up period, and few describe late recurrence rates. This communication reviews the experience of our medical center with this procedure over a 4-year period, and provides a new perspective on the late recurrence rate. Summary of Cases Patient Population This series consisted of

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Kenneth J. Rothman and James G. Wepsic

T rigeminal neuralgia has been observed to occur more frequently on the right side of the face. 6 Gardner, et al. , 3, 4 reported that the apex of the petrous ridge, on which the trigeminal sensory root rests, is usually higher on the right side than the left. They found that among the 80% of 115 cases in which one apex was higher than the other, the pain was on the same side as the higher apex in 75%, and suggested that elevation of the petrous apex increases the probability of trigeminal neuralgia occurring on that side of the face. Our study evaluates

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Diaa Bahgat, Dibyendu K. Ray, Ahmed M. Raslan, Shirley McCartney and Kim J. Burchiel

your medication  a. Was there a time when you stopped medication? □ YES □ NO  b. Have you needed to change the medication dose (whether by increasing or decreasing dosage) □ YES □ NO  c. Have you changed the medication itself by adding or substituting a different drug? □ YES □ NO 6. Have you had multiple procedures for your trigeminal neuralgia? (if yes) □ YES □ NO  a. How many? _____________  b. What were they? _____________  c. What was the outcome of each? _____________  d. What was the average duration of

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Wishwa N. Kapoor and Peter J. Jannetta

S yncope , seizures, and cardiac arrest are well described in association with glossopharyngeal neuralgia, 3 but have not previously been reported with neuralgia affecting other cranial or peripheral nerves. We report a patient who had trigeminal neuralgia associated with syncope and seizures due to bradycardia and asystole. The episodes of loss of consciousness did not recur after a pacemaker was inserted. The neuralgia and bradycardia later resolved with microvascular decompression of the fifth cranial nerve. Case Report This 60-year-old man was in

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Percutaneous trigeminal ganglion compression for trigeminal neuralgia

Experience in 22 patients and review of the literature

Jeffrey A. Brown and Mark C. Preul

. A year later, Shelden, et al. , reported on 10 patients with trigeminal neuralgia treated by decompressing peripheral branches of the trigeminal nerve at the foramen ovale or rotundum, and concluded that the common success factor between these two procedures was operative trauma. Shelden, et al. , 20 then treated 115 patients by subtemporal craniotomy and selective ganglion compression. All 115 patients were initially relieved of their pain, with a 14% to 20% recurrence rate. Morbidity included minimal to moderate sensory loss in 28%, dysesthesia in 12%, and

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Manuel J. Arias

S ince its introduction by Håkanson in 1981, 3 percutaneous retrogasserian glycerol rhizotomy (PRGR) has become a valuable method for the surgical treatment of trigeminal neuralgia. 1, 4, 5 The objective of this procedure is the percutaneous placement of a small amount of pure sterile glycerol on the intracisternal trigeminal rootlets corresponding to the affected division. To assure accurate intracisternal placement of the needle tip, metrizamide trigeminal cisternography has been advocated as a necessary technical phase of the method. 3, 4 However

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Kenichi Amagasaki, Shoko Abe, Saiko Watanabe, Kazuaki Naemura and Hiroshi Nakaguchi

T rigeminal neuralgia is considered to be a type of neurovascular compression syndrome 4 , 7 typically caused by compression of the trigeminal nerve by the superior cerebellar artery (SCA) or other arteries branching from the vertebral and basilar arteries, and sometimes by veins or tumors. 2 , 3 We report a case of trigeminal neuralgia caused by an artery that had almost encircled the nerve, which was successfully decompressed surgically, and discuss the anatomy of the offending artery and trigeminal nerve root vasculature. Case Report

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Ronald F. Young

A variety of methods are currently in use for treatment of trigeminal neuralgia. These include pharmacological agents as well as open and percutaneous surgical procedures. 5, 17 The usual approach utilizes pharmacological agents initially and reserves surgical therapy for patients whose pain is not effectively relieved by medications or who are intolerant of medications due to toxicity or allergic reactions. The most frequently used surgical approaches include microvascular decompression of the trigeminal nerve via retromastoid craniectomy or percutaneous