Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health providers.Transcranial direct current stimulation is a non-invasive stimulation technique which finds new utility ...Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health providers.Transcranial direct current stimulation is a non-invasive stimulation technique which finds new utility in managing pain.There-fore,the introduction of alternative,non-invasive,safe,and effective methods should be considered in treating patients with trigeminal neuralgia unresponsive to conventional treatment.展开更多
Objective:To analyze the degree of psychological distress among elderly patients with recurrent trigeminal neuralgia and its influencing factors.Methods:A single-center cross-sectional study was conducted on 126 elder...Objective:To analyze the degree of psychological distress among elderly patients with recurrent trigeminal neuralgia and its influencing factors.Methods:A single-center cross-sectional study was conducted on 126 elderly patients with recurrent trigeminal neuralgia who visited the Pain Department of our hospital from March 2022 to April 2024.Logistic regression analysis was employed to evaluate the factors influencing psychological distress,based on general patient data,the Distress Thermometer(DT),the Perceived Social Support from Family Scale(PSS-Fa),and the Pitsburgh Sleep Quality Index(PSQI).Results:Among the 126 elderly patients with recurrent trigeminal neuralgia,those with a DT score≥4(72 patients,57.14%)were more prevalent than those with a DT score<4(54 patients,42.86%).The average DT score for all patients was 4.35±1.72.Patients in the DT score≥4 group were older than those in the DT score<4 group(t=4.207,P=0.000),had lower PSS-Fa scores(t=5.925,P=0.000),and had higher PSQI scores(t=17.858,P=0.000).There were no statistically significant differences in gender,marital status,residence area,education level,disease type,or pain location(all P>0.05).Older age and poor sleep quality were identified as independent risk factors for psychological distress in elderly patients with recurrent trigeminal neuralgia(OR=1.258,OR=1.713,both P<0.05),while higher levels of family support were identified as a protective factor(OR=0.581,P=0.025).Conclusion:Elderly patients with recurrent trigeminal neuralgia experience psychological distress,and the degree of severity depends on age,quality of sleep,and level of family support.展开更多
Twenty-five cases of Primary trigeminal neuralgia were treated satisfactorily by acupuncture at Xiaguan (St 7) through to the sphenopalatine ganglion, which is an important vegetative ganglion in the head.
In the present paper, 8 cases of trigeminal neuralgia were treated with acupuncture of Tianrong point(SI 17) and they were all cured. Tianrong point is located at the superior cervical ganglion of the sympathetic trun...In the present paper, 8 cases of trigeminal neuralgia were treated with acupuncture of Tianrong point(SI 17) and they were all cured. Tianrong point is located at the superior cervical ganglion of the sympathetic trunck. When needling the point the needle punctures directly on the sympathetic trunck inducing endings of postganglionic fibers to release adrenaline, which exertes regulatory effect on sensory cells in the semilunar ganglion of trigeminal nerves and vessels of the face, so as to attain analgesic effect.展开更多
96 cases of trigeminal neuralgia were treated by acupuncture. As a result, 82 cases were cured accounting for 85. 1 %, 12 cases improved accounting for 12. 5 % and 2 cases were ineffective accounting for 2. 08%. The t...96 cases of trigeminal neuralgia were treated by acupuncture. As a result, 82 cases were cured accounting for 85. 1 %, 12 cases improved accounting for 12. 5 % and 2 cases were ineffective accounting for 2. 08%. The total effective rate was 97. 9%. The method of treatment is effective for trigeminal neuralgia. It is convenient, takes analgesic effect guickly and does not have any side-effect.展开更多
Trigeminal neuralgia refers to repeated paroxysmal, transient, and severe pain in the innervation area of the trigeminal nerve. The cause of this disease has not yet been fully elucidated. There is no special therapeu...Trigeminal neuralgia refers to repeated paroxysmal, transient, and severe pain in the innervation area of the trigeminal nerve. The cause of this disease has not yet been fully elucidated. There is no special therapeutic measure to treat it. The authors have achieved relatively satisfactory curative effect in seven patients with trigeminal neuralgia by acupuncture at Renying point (St 9). This is reported as follows.展开更多
Case History Name: Liu; Sex: female; Age: 51; Occupation: housewife; Date of first visit: Nov. 4, 1985. Chief complaint: Right-side facial pain for 6 months. In the beginning the patient suspected it to be toothache w...Case History Name: Liu; Sex: female; Age: 51; Occupation: housewife; Date of first visit: Nov. 4, 1985. Chief complaint: Right-side facial pain for 6 months. In the beginning the patient suspected it to be toothache which was later ruled out by the dentist. The attack was characterized by paroxysmal pain and展开更多
Trigeminal Neuralgia is often found in female between 40-60 years old, marked by sudden severe pain on the face (a feeling of knife cutting, electric shock), and it is characterized by sudden, paroxysmal and periodica...Trigeminal Neuralgia is often found in female between 40-60 years old, marked by sudden severe pain on the face (a feeling of knife cutting, electric shock), and it is characterized by sudden, paroxysmal and periodical attack and triggered by touch). The attack usually lasts for 1 to 2 minutes with different intervals. The patient’s life quality can be seriously affected. It is mainly treated with orally taken drugs in western internal department but without satisfactory result, and with local closing therapy in surgical department. The problem may reoccur half a year later in most patients complicated with facial paralysis, so western medicine is not likely to be accepted by the patients. The author has tried to apply abdominal acupuncture in the treatment of 25 cases of trigeminal neuralgia with good effect. The result is as follows.展开更多
Objective:To compare the clinical effectiveness of gamma knife radiosugery combined with acupuncture therapy and microvascular decompression in the treatment of idiopathic trigeminal neuralgia.Methods:A total of 93 pa...Objective:To compare the clinical effectiveness of gamma knife radiosugery combined with acupuncture therapy and microvascular decompression in the treatment of idiopathic trigeminal neuralgia.Methods:A total of 93 patients with primary trigeminal neuralgia added to Nanchang University Hospital from November 2016 to October 2018 were selected,it was divided randomly into the control group(45 cases)and the study group(48 cases).The control group was treated with microvascular decompression and the study group used gamma knife radiosurgery combined with acupuncture therapy.The study compared the immediate pain relief rate,Visual Analogue Scale(VAS)scores,completion rate,recurrence rate,hospitalization days,total treatment duration,total treatment cost and total effective rate of treatment in 2 groups.Results:Comparison of the same group after treatment:the VAS score with 24 hours of treatment in the control group was(5.33±0.49),with a significant difference from the pre-treatment VAS score(8.62±0.13);The VAS score with 24 hours of treatment in the study group was(5.96±0.58),with a significant difference from the pre-treatment VAS score(8.54±0.25).After treatment,immediate effect,parent effect,acute and chronic complements of the control group was 25,5,2 and 7 cases,and the study group was 6,25,7 and 1,respectively.There were significant differences between the two groups;The comparison of hospitalization days,total treatment duration,total treatment cost was statistically significant(P<0.05);There were no significant difference in immediate pain rate,VAS score,total incidence of complications,recurrence rate,and total effectiveness of treatment between the two groups(P>0.05).Conclusion:Both microvascular decompression and gamma knife radiosurgery combined with acupuncture therapy can safe and effective treatment idiopathic trigeminal neuralgia patients,and for patients with good health,can tolerance all-hemp surgery,there are contraindicaindications to acupuncture therapy,microvascular decompression treatment can be chosen,while patients who are weak,cannot tolerante all-hemp surgery or resist surgery,economic difficulties,and can choose gamma knife radiosurgery combined with acupuncture therapy treatment.展开更多
OBJECTIVE To assess the effi⁃cacy and safety of acupuncture-related treat⁃ments for postherpetic neuralgia(PHN),identify the most effective acupuncture and related treat⁃ments.METHODS PubMed,Cochrane Central Register ...OBJECTIVE To assess the effi⁃cacy and safety of acupuncture-related treat⁃ments for postherpetic neuralgia(PHN),identify the most effective acupuncture and related treat⁃ments.METHODS PubMed,Cochrane Central Register of Controlled Trials,Embase,Web of Science,and four Chinese databases,a clinical research registration platform,and grey literature were searched.We evaluated the risk of bias and quality in the included studies and per⁃formed a Bayesian multiple network meta-analysis.RESULTS We included 29 randomized controlled trials comprising 1973 patients,of which approximately 17.24%showed a high risk of bias.According to the Jadad scale,2,16,and 11 studies were high,medium,and low quality,respectively.The pairwise meta-analysis results revealed that the efficacy of all acupuncture-related treatments for pain relief related to PHN showed the difference was statistically significant com⁃pared with that of antiepileptics.The network meta-analysis results showed that pricking and cupping plus antiepileptics were the most effective,followed by electroacupuncture(EA)plus antiepileptics for pain relief in patients with PHN.EA plus antiepileptics ranked the best regarding reduced Pittsburgh Sleep Quality Index and Self-Rating Depression Scale scores in patients with PHN.No results were found regarding total response rate or quality of life among this study.Acupuncture-related treatments showed a lower incidence of adverse events than that of antiepi⁃leptics-related treatments.CONCLUSION Acu⁃puncture-related therapies may be potential treat⁃ment options for PHN and are relatively safe.Pricking and cupping plus antiepileptics are the most effective techniques for pain relief.EA plus antiepileptics is the best approach for improving insomnia and depression symptoms of PHN.展开更多
BACKGROUND In this randomized controlled trial(RCT)comparing current acupuncture with carbamazepine for trigeminal neuralgia,meta-and sequential analyses were utilized.AIM To guide clinical decision making regarding t...BACKGROUND In this randomized controlled trial(RCT)comparing current acupuncture with carbamazepine for trigeminal neuralgia,meta-and sequential analyses were utilized.AIM To guide clinical decision making regarding the treatment of trigeminal neuralgia with carbamazepine.METHODS 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 2020.Risk 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 0.9.5.10 Beta sequential analysis,GRADE was used to assess the evidence,and adverse reactions were documented.RESULTS This study analyzed 16 RCTs with a total of 1231 participants.The 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 quality.Cumulative 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 carbamazepine.CONCLUSION 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.展开更多
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...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 2009.Thirty patients had CTN,and 27 had MTN.Outcomes 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 years.Our results showed that the patients with MTN were younger,tended to have bilaterial involvement of the first division,and were unresponsive to treatment.All surgeries were completed smoothly.About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT.The 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,respectively.The rates of pain relief for both groups leveled off at 2 years.Complications included numbness,dysesthesia,and anesthesia dolorosa.RFT did not cause any deaths and complications were low.The treatment was very effective for CTN and,to some degrees,effective for MTN.If numbness,dysesthesia,and anesthesia dolorosa are limited to the trigger area,QOL will be greatly improved.展开更多
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 recei...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.展开更多
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...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.展开更多
In the present paper, 45 cases of acute trigemina] neuralgia were treated and observed by comparative method. Results showed no significant difference in transient analgesic effect (P】 0.05) but a significant differe...In the present paper, 45 cases of acute trigemina] neuralgia were treated and observed by comparative method. Results showed no significant difference in transient analgesic effect (P】 0.05) but a significant difference in therapeutic effect (P【 0.01) between the treatment and control groups. This indicates that blood-letting puncture with cupping is an effective therapy for the disease.展开更多
Objective: To investigate the successful rate and accuracy of percutaneous radiofrequency thermocoagulation (PRT) for treatment of primary trigeminal neuralgia (PTN) with customized navigated template via three dimens...Objective: To investigate the successful rate and accuracy of percutaneous radiofrequency thermocoagulation (PRT) for treatment of primary trigeminal neuralgia (PTN) with customized navigated template via three dimensional (3D) printing technique. Methods: 65 patients with PTN were recruited from January 2014 to March 2015 and randomly divided into two groups: template group (n = 28) and traditional group (n = 37). The patients in traditional group received PRT under guidance of C-arm fluoroscopy, while the ones in template group were treated with customized navigated templates. The data of time, depth and accuracy rate of puncture, the average effective dose equivalent of radiation, complications after operation were collected and analyzed. Results: No intra-operative failures occurred in the template group: the pain was alleviated immediately after operation. Accuracy rate of the template group was 100% while 96% was achieved in traditional group. However, the average time of puncture by the template was significantly reduced compared with traditional group (2.37 ± 0.64 minutes and 24.2 ± 6.55 minutes, respectively;P 0.05). No complications were observed in template group while several complications such as blooding, leakage of cerebrospinal fluid and dizziness were observed in traditional group. Conclusion: The application of customized template is advocated for improving the accuracy of PRT.展开更多
Objective To evaluate the effectiveness of three-dimensional computed tomography (3D-CT) guided radiofrequency trige- minal rhizotomy (RF-TR) in treatment of idiopathic trigeminal neuralgia (ITN). Methods From 1999 to...Objective To evaluate the effectiveness of three-dimensional computed tomography (3D-CT) guided radiofrequency trige- minal rhizotomy (RF-TR) in treatment of idiopathic trigeminal neuralgia (ITN). 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℃ depend- ing on the pain distribution and the age of patient. Results 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.展开更多
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 ganglio...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.展开更多
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 unst...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 pain.Herein,we report a case of oxcarbazepineinduced lower leg weakness in a patient with trigeminal neuralgia and summarize the diagnosis,treatment,and changes of clinical symptoms.CASE 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 branch.He was prescribed oxcarbazepine(600 mg/d),milnacipran(25 mg/d),and oxycodone/naloxone(20 mg/10 mg/d)for four years.Four years later,the patient experienced symptoms associated with spinal stenosis,including pain in the lower extremities and unsteady gait.His serum sodium level was 127 mmol/L.Assuming oxcarbazepine to be the cause of the hyponatremia,oxcarbazepine administration was put on hold and the patient was switched to topiramate.At subsequent visit,the patient’s serum sodium level had normalized to 143 mmol/L and his unsteady gait had improved.CONCLUSION Oxcarbazepine-induced hyponatremia may cause lower extremity weakness and unsteady gait,which should be differentiated from those caused by spinal stenosis.展开更多
This study examined the analgesic effect of diprospan in rats with trigeminal neuralgia.Rat model of trigeminal neuralgic pain was established by loosely ligating the left infraorbital branch of the trigeminal nerve.A...This study examined the analgesic effect of diprospan in rats with trigeminal neuralgia.Rat model of trigeminal neuralgic pain was established by loosely ligating the left infraorbital branch of the trigeminal nerve.After 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 group.The pain threshold(PT) in the left infraorbital area was measured before and 2,6,and 8 weeks after the administration.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 method.The 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.展开更多
文摘Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health providers.Transcranial direct current stimulation is a non-invasive stimulation technique which finds new utility in managing pain.There-fore,the introduction of alternative,non-invasive,safe,and effective methods should be considered in treating patients with trigeminal neuralgia unresponsive to conventional treatment.
文摘Objective:To analyze the degree of psychological distress among elderly patients with recurrent trigeminal neuralgia and its influencing factors.Methods:A single-center cross-sectional study was conducted on 126 elderly patients with recurrent trigeminal neuralgia who visited the Pain Department of our hospital from March 2022 to April 2024.Logistic regression analysis was employed to evaluate the factors influencing psychological distress,based on general patient data,the Distress Thermometer(DT),the Perceived Social Support from Family Scale(PSS-Fa),and the Pitsburgh Sleep Quality Index(PSQI).Results:Among the 126 elderly patients with recurrent trigeminal neuralgia,those with a DT score≥4(72 patients,57.14%)were more prevalent than those with a DT score<4(54 patients,42.86%).The average DT score for all patients was 4.35±1.72.Patients in the DT score≥4 group were older than those in the DT score<4 group(t=4.207,P=0.000),had lower PSS-Fa scores(t=5.925,P=0.000),and had higher PSQI scores(t=17.858,P=0.000).There were no statistically significant differences in gender,marital status,residence area,education level,disease type,or pain location(all P>0.05).Older age and poor sleep quality were identified as independent risk factors for psychological distress in elderly patients with recurrent trigeminal neuralgia(OR=1.258,OR=1.713,both P<0.05),while higher levels of family support were identified as a protective factor(OR=0.581,P=0.025).Conclusion:Elderly patients with recurrent trigeminal neuralgia experience psychological distress,and the degree of severity depends on age,quality of sleep,and level of family support.
文摘Twenty-five cases of Primary trigeminal neuralgia were treated satisfactorily by acupuncture at Xiaguan (St 7) through to the sphenopalatine ganglion, which is an important vegetative ganglion in the head.
文摘In the present paper, 8 cases of trigeminal neuralgia were treated with acupuncture of Tianrong point(SI 17) and they were all cured. Tianrong point is located at the superior cervical ganglion of the sympathetic trunck. When needling the point the needle punctures directly on the sympathetic trunck inducing endings of postganglionic fibers to release adrenaline, which exertes regulatory effect on sensory cells in the semilunar ganglion of trigeminal nerves and vessels of the face, so as to attain analgesic effect.
文摘96 cases of trigeminal neuralgia were treated by acupuncture. As a result, 82 cases were cured accounting for 85. 1 %, 12 cases improved accounting for 12. 5 % and 2 cases were ineffective accounting for 2. 08%. The total effective rate was 97. 9%. The method of treatment is effective for trigeminal neuralgia. It is convenient, takes analgesic effect guickly and does not have any side-effect.
文摘Trigeminal neuralgia refers to repeated paroxysmal, transient, and severe pain in the innervation area of the trigeminal nerve. The cause of this disease has not yet been fully elucidated. There is no special therapeutic measure to treat it. The authors have achieved relatively satisfactory curative effect in seven patients with trigeminal neuralgia by acupuncture at Renying point (St 9). This is reported as follows.
文摘Case History Name: Liu; Sex: female; Age: 51; Occupation: housewife; Date of first visit: Nov. 4, 1985. Chief complaint: Right-side facial pain for 6 months. In the beginning the patient suspected it to be toothache which was later ruled out by the dentist. The attack was characterized by paroxysmal pain and
文摘Trigeminal Neuralgia is often found in female between 40-60 years old, marked by sudden severe pain on the face (a feeling of knife cutting, electric shock), and it is characterized by sudden, paroxysmal and periodical attack and triggered by touch). The attack usually lasts for 1 to 2 minutes with different intervals. The patient’s life quality can be seriously affected. It is mainly treated with orally taken drugs in western internal department but without satisfactory result, and with local closing therapy in surgical department. The problem may reoccur half a year later in most patients complicated with facial paralysis, so western medicine is not likely to be accepted by the patients. The author has tried to apply abdominal acupuncture in the treatment of 25 cases of trigeminal neuralgia with good effect. The result is as follows.
基金Science and Technology Plan Project of Jiangxi Provincial Health and Health Commission(20200506).
文摘Objective:To compare the clinical effectiveness of gamma knife radiosugery combined with acupuncture therapy and microvascular decompression in the treatment of idiopathic trigeminal neuralgia.Methods:A total of 93 patients with primary trigeminal neuralgia added to Nanchang University Hospital from November 2016 to October 2018 were selected,it was divided randomly into the control group(45 cases)and the study group(48 cases).The control group was treated with microvascular decompression and the study group used gamma knife radiosurgery combined with acupuncture therapy.The study compared the immediate pain relief rate,Visual Analogue Scale(VAS)scores,completion rate,recurrence rate,hospitalization days,total treatment duration,total treatment cost and total effective rate of treatment in 2 groups.Results:Comparison of the same group after treatment:the VAS score with 24 hours of treatment in the control group was(5.33±0.49),with a significant difference from the pre-treatment VAS score(8.62±0.13);The VAS score with 24 hours of treatment in the study group was(5.96±0.58),with a significant difference from the pre-treatment VAS score(8.54±0.25).After treatment,immediate effect,parent effect,acute and chronic complements of the control group was 25,5,2 and 7 cases,and the study group was 6,25,7 and 1,respectively.There were significant differences between the two groups;The comparison of hospitalization days,total treatment duration,total treatment cost was statistically significant(P<0.05);There were no significant difference in immediate pain rate,VAS score,total incidence of complications,recurrence rate,and total effectiveness of treatment between the two groups(P>0.05).Conclusion:Both microvascular decompression and gamma knife radiosurgery combined with acupuncture therapy can safe and effective treatment idiopathic trigeminal neuralgia patients,and for patients with good health,can tolerance all-hemp surgery,there are contraindicaindications to acupuncture therapy,microvascular decompression treatment can be chosen,while patients who are weak,cannot tolerante all-hemp surgery or resist surgery,economic difficulties,and can choose gamma knife radiosurgery combined with acupuncture therapy treatment.
基金National Key Research and Development plan for the Modernization of Traditional Chinese Medicine (2018YFC1707700)National Key Research and Development plan for the Modernization of Traditional Chinese Medicine (2018YFC1707706)National Administration of Traditional Chinese Medicine Evidencebased Capacity Building Project (2019XZZXZJ005)
文摘OBJECTIVE To assess the effi⁃cacy and safety of acupuncture-related treat⁃ments for postherpetic neuralgia(PHN),identify the most effective acupuncture and related treat⁃ments.METHODS PubMed,Cochrane Central Register of Controlled Trials,Embase,Web of Science,and four Chinese databases,a clinical research registration platform,and grey literature were searched.We evaluated the risk of bias and quality in the included studies and per⁃formed a Bayesian multiple network meta-analysis.RESULTS We included 29 randomized controlled trials comprising 1973 patients,of which approximately 17.24%showed a high risk of bias.According to the Jadad scale,2,16,and 11 studies were high,medium,and low quality,respectively.The pairwise meta-analysis results revealed that the efficacy of all acupuncture-related treatments for pain relief related to PHN showed the difference was statistically significant com⁃pared with that of antiepileptics.The network meta-analysis results showed that pricking and cupping plus antiepileptics were the most effective,followed by electroacupuncture(EA)plus antiepileptics for pain relief in patients with PHN.EA plus antiepileptics ranked the best regarding reduced Pittsburgh Sleep Quality Index and Self-Rating Depression Scale scores in patients with PHN.No results were found regarding total response rate or quality of life among this study.Acupuncture-related treatments showed a lower incidence of adverse events than that of antiepi⁃leptics-related treatments.CONCLUSION Acu⁃puncture-related therapies may be potential treat⁃ment options for PHN and are relatively safe.Pricking and cupping plus antiepileptics are the most effective techniques for pain relief.EA plus antiepileptics is the best approach for improving insomnia and depression symptoms of PHN.
文摘BACKGROUND In this randomized controlled trial(RCT)comparing current acupuncture with carbamazepine for trigeminal neuralgia,meta-and sequential analyses were utilized.AIM To guide clinical decision making regarding the treatment of trigeminal neuralgia with carbamazepine.METHODS 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 2020.Risk 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 0.9.5.10 Beta sequential analysis,GRADE was used to assess the evidence,and adverse reactions were documented.RESULTS This study analyzed 16 RCTs with a total of 1231 participants.The 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 quality.Cumulative 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 carbamazepine.CONCLUSION 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.
基金supported by a grant from the Beijing Municipal Project of Science and Technology (No.Y0204003040631)
文摘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 2009.Thirty patients had CTN,and 27 had MTN.Outcomes 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 years.Our results showed that the patients with MTN were younger,tended to have bilaterial involvement of the first division,and were unresponsive to treatment.All surgeries were completed smoothly.About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT.The 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,respectively.The rates of pain relief for both groups leveled off at 2 years.Complications included numbness,dysesthesia,and anesthesia dolorosa.RFT did not cause any deaths and complications were low.The treatment was very effective for CTN and,to some degrees,effective for MTN.If numbness,dysesthesia,and anesthesia dolorosa are limited to the trigger area,QOL will be greatly improved.
文摘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.
文摘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.
文摘In the present paper, 45 cases of acute trigemina] neuralgia were treated and observed by comparative method. Results showed no significant difference in transient analgesic effect (P】 0.05) but a significant difference in therapeutic effect (P【 0.01) between the treatment and control groups. This indicates that blood-letting puncture with cupping is an effective therapy for the disease.
文摘Objective: To investigate the successful rate and accuracy of percutaneous radiofrequency thermocoagulation (PRT) for treatment of primary trigeminal neuralgia (PTN) with customized navigated template via three dimensional (3D) printing technique. Methods: 65 patients with PTN were recruited from January 2014 to March 2015 and randomly divided into two groups: template group (n = 28) and traditional group (n = 37). The patients in traditional group received PRT under guidance of C-arm fluoroscopy, while the ones in template group were treated with customized navigated templates. The data of time, depth and accuracy rate of puncture, the average effective dose equivalent of radiation, complications after operation were collected and analyzed. Results: No intra-operative failures occurred in the template group: the pain was alleviated immediately after operation. Accuracy rate of the template group was 100% while 96% was achieved in traditional group. However, the average time of puncture by the template was significantly reduced compared with traditional group (2.37 ± 0.64 minutes and 24.2 ± 6.55 minutes, respectively;P 0.05). No complications were observed in template group while several complications such as blooding, leakage of cerebrospinal fluid and dizziness were observed in traditional group. Conclusion: The application of customized template is advocated for improving the accuracy of PRT.
文摘Objective To evaluate the effectiveness of three-dimensional computed tomography (3D-CT) guided radiofrequency trige- minal rhizotomy (RF-TR) in treatment of idiopathic trigeminal neuralgia (ITN). 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℃ depend- ing on the pain distribution and the age of patient. Results 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.
文摘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.
文摘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 pain.Herein,we report a case of oxcarbazepineinduced lower leg weakness in a patient with trigeminal neuralgia and summarize the diagnosis,treatment,and changes of clinical symptoms.CASE 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 branch.He was prescribed oxcarbazepine(600 mg/d),milnacipran(25 mg/d),and oxycodone/naloxone(20 mg/10 mg/d)for four years.Four years later,the patient experienced symptoms associated with spinal stenosis,including pain in the lower extremities and unsteady gait.His serum sodium level was 127 mmol/L.Assuming oxcarbazepine to be the cause of the hyponatremia,oxcarbazepine administration was put on hold and the patient was switched to topiramate.At subsequent visit,the patient’s serum sodium level had normalized to 143 mmol/L and his unsteady gait had improved.CONCLUSION Oxcarbazepine-induced hyponatremia may cause lower extremity weakness and unsteady gait,which should be differentiated from those caused by spinal stenosis.
基金supported by a grant from the Science and Technique Bureau of Tai'an City(No.2003-52)
文摘This study examined the analgesic effect of diprospan in rats with trigeminal neuralgia.Rat model of trigeminal neuralgic pain was established by loosely ligating the left infraorbital branch of the trigeminal nerve.After 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 group.The pain threshold(PT) in the left infraorbital area was measured before and 2,6,and 8 weeks after the administration.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 method.The 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.