Trigeminal Nerve

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Mojgan Hodaie - One of the best experts on this subject based on the ideXlab platform.

  • Histopathological effects of radiosurgery on a human Trigeminal Nerve
    Surgical Neurology International, 2014
    Co-Authors: Faisal Al-otaibi, Hindi Alhindi, Adnan Alhebshi, Monirah Albloushi, Saleh S. Baeesa, Mojgan Hodaie
    Abstract:

    Background: Radiosurgery is a well‑established treatment modality for medically refractory Trigeminal neuralgia. The exact mechanism of pain relief after radiosurgery is not clearly understood. Histopathology examination of the Trigeminal Nerve in humans after radiosurgery is rarely performed and has produced controversial results. Case Description: We report on a 45‑year‑old female who received radiosurgery treatment for Trigeminal neuralgia by Cyberknife. A 6‑mm portion of the cisternal segment of Trigeminal Nerve received a dose of 60 Gy. The clinical benefit started 10 days after therapy and continued for 8 months prior to a recurrence of her previous symptoms associated with mild background pain. She underwent microvascular decompression and partial sensory root sectioning. Atrophied Trigeminal Nerve rootlets were grossly noted intraoperatively under surgical microscope associated with changes in Trigeminal Nerve color to gray. A biopsy from the inferolateral surface of the Nerve proximal to the midcisternal segment showed histological changes in the form of fibrosis and axonal degeneration. Conclusion: This case study supports the evidence of histological damage of the Trigeminal Nerve fibers after radiosurgery therapy. Whether or not the presence and degree of Nerve damage correlate with the degree of clinical benefit and side effects are not revealed by this study and need to be explored in future studies.

  • Histopathological effects of radiosurgery on a human Trigeminal Nerve.
    Surgical neurology international, 2014
    Co-Authors: Faisal Al-otaibi, Hindi Alhindi, Adnan Alhebshi, Monirah Albloushi, Saleh S. Baeesa, Mojgan Hodaie
    Abstract:

    Radiosurgery is a well-established treatment modality for medically refractory Trigeminal neuralgia. The exact mechanism of pain relief after radiosurgery is not clearly understood. Histopathology examination of the Trigeminal Nerve in humans after radiosurgery is rarely performed and has produced controversial results. We report on a 45-year-old female who received radiosurgery treatment for Trigeminal neuralgia by Cyberknife. A 6-mm portion of the cisternal segment of Trigeminal Nerve received a dose of 60 Gy. The clinical benefit started 10 days after therapy and continued for 8 months prior to a recurrence of her previous symptoms associated with mild background pain. She underwent microvascular decompression and partial sensory root sectioning. Atrophied Trigeminal Nerve rootlets were grossly noted intraoperatively under surgical microscope associated with changes in Trigeminal Nerve color to gray. A biopsy from the inferolateral surface of the Nerve proximal to the midcisternal segment showed histological changes in the form of fibrosis and axonal degeneration. This case study supports the evidence of histological damage of the Trigeminal Nerve fibers after radiosurgery therapy. Whether or not the presence and degree of Nerve damage correlate with the degree of clinical benefit and side effects are not revealed by this study and need to be explored in future studies.

  • abnormal Trigeminal Nerve microstructure and brain white matter in idiopathic Trigeminal neuralgia
    Pain, 2014
    Co-Authors: Mojgan Hodaie, Danielle D Desouza, Karen D Davis
    Abstract:

    Abstract Idiopathic Trigeminal neuralgia (TN) is classically associated with neurovascular compression (NVC) of the Trigeminal Nerve at the root entry zone (REZ), but NVC-induced structural alterations are not always apparent on conventional imaging. Previous studies report lower fractional anisotropy (FA) in the affected Trigeminal Nerves of TN patients using diffusion tensor imaging (DTI). However, it is not known if TN patients have Trigeminal Nerve abnormalities of mean, radial, or axial diffusivity (MD, RD, AD – metrics linked to neuroinflammation and edema) or brain white matter (WM) abnormalities. DTI scans in 18 right-sided TN patients and 18 healthy controls were retrospectively analyzed to extract FA, RD, AD, and MD from the Trigeminal Nerve REZ, and Tract-Based Spatial Statistics (TBSS) was used to assess brain WM. In patients, the affected Trigeminal Nerve had lower FA, and higher RD, AD, and MD was found bilaterally compared to controls. Group TBSS (P

  • tractography delineates microstructural changes in the Trigeminal Nerve after focal radiosurgery for Trigeminal neuralgia
    PLOS ONE, 2012
    Co-Authors: Mojgan Hodaie, David Chen, Jessica Quan, Normand Laperriere
    Abstract:

    Purpose Focal radiosurgery is a common treatment modality for Trigeminal neuralgia (TN), a neuropathic facial pain condition. Assessment of treatment effectiveness is primarily clinical, given the paucity of investigational tools to assess Trigeminal Nerve changes. Since diffusion tensor imaging (DTI) provides information on white matter microstructure, we explored the feasibility of Trigeminal Nerve tractography and assessment of DTI parameters to study microstructural changes after treatment. We hypothesized that Trigeminal tractography provides more information than 2D-MR imaging, allowing detection of unique, focal changes in the target area after radiosurgery. Changes in specific diffusivities may provide insight into the mechanism of action of radiosurgery on the Trigeminal Nerve. Methods and Materials Five TN patients (4 females, 1 male, average age 67 years) treated with Gamma Knife radiosurgery, 80 Gy/100% isodose line underwent 3Tesla MR Trigeminal Nerve tractography before and sequentially up to fourteen months after treatment. Fractional anisotropy (FA), radial (RD) and axial (AD) diffusivities were calculated for the radiosurgical target area defined as the region-of-interest. Areas outside target and the contralateral Nerve served as controls. Results Trigeminal tractography accurately detected the radiosurgical target. Radiosurgery resulted in 47% drop in FA values at the target with no significant change in FA outside the target, demonstrating highly focal changes after treatment. RD but not AD changed markedly, suggesting that radiosurgery primarily affects myelin. Tractography was more sensitive than conventional gadolinium-enhanced post-treatment MR, since FA changes were detected regardless of Trigeminal Nerve enhancement. In subjects with long term follow-up, recovery of FA/RD correlated with pain recurrence. Conclusions DTI parameters accurately detect the effects of focal radiosurgery on the Trigeminal Nerve, serving as an in vivo imaging tool to study TN. This study is a proof of principle for further assessment of DTI parameters to understand the pathophysiology of TN and treatment effects.

James K Liu - One of the best experts on this subject based on the ideXlab platform.

  • malignant peripheral Nerve sheath tumors of the Trigeminal Nerve a systematic review of 36 cases
    Neurosurgical Focus, 2013
    Co-Authors: Richard F Schmidt, Frederick Yick, Zain Boghani, Jean Anderson Eloy, James K Liu
    Abstract:

    Object Malignant peripheral Nerve sheath tumors (MPNSTs) are a rare form of malignancy arising from the Schwann cells of peripheral Nerves. MPNSTs of the Trigeminal Nerve are exceptionally rare, with only a handful of reports in the literature. These tumors are typically very aggressive, resulting in significant patient morbidity and a generally grim prognosis. Most current reports suggest that radical resection with radiation therapy offers the best benefit. In this study, the authors systematically reviewed the world English-language literature on MPNSTs of the Trigeminal Nerve to analyze the presentations, treatment options, and outcomes for patients with this disease. Methods A literature search for MPNSTs of the Trigeminal Nerve confined to nonanimal, English-language articles was conducted utilizing the PubMed database, with additional cases chosen from the references of selected articles. Only cases of confirmed MPNSTs of the Trigeminal Nerve or its peripheral branches, based upon surgical, patholo...

Todd Whitehurst - One of the best experts on this subject based on the ideXlab platform.

  • pilot study of Trigeminal Nerve stimulation tns for epilepsy a proof of concept trial
    Epilepsia, 2006
    Co-Authors: Christopher M. Degiorgio, Alan Shewmon, Diane Murray, Todd Whitehurst
    Abstract:

    Summary: The safety and preliminary efficacy of Trigeminal Nerve stimulation (TNS) for epilepsy was evaluated in a pilot feasibility study of transcutaneous stimulation of the infraorbital and supraorbital branches of the Trigeminal Nerve. TNS was well tolerated. Four (57%) of seven subjects who completed ≥3 months experienced a ≥50% reduction in seizure frequency. The results of this pilot study support further investigation into the safety and efficacy of TNS for epilepsy. Key Words: Trigeminal Nerve stimulation—Epilepsy—Neurostimulation.

  • Trigeminal Nerve stimulation for epilepsy.
    Neurology, 2003
    Co-Authors: Christopher M. Degiorgio, D. Alan Shewmon, Todd Whitehurst
    Abstract:

    Epilepsy in many patients remains poorly controlled despite the introduction of new antiepileptic drugs (AEDs).1 Neurostimulation, including vagus Nerve stimulation (VNS), is a promising alternative to AEDs.2 The mechanism of VNS involves the locus ceruleus (LC) and nucleus solitarius (NTS).3,4⇓ As the LC and NTS project to the Trigeminal nucleus, stimulation of the Trigeminal Nerve may also activate similar pathways to VNS.4-6⇓⇓ The Trigeminal Nerve, via cutaneous branches, offers a noninvasive method of neurostimulation. Recently, infraorbital Trigeminal Nerve stimulation (TNS) reduced pentylenetetrazol-induced seizures in rats.7 Given the potent antiepileptic effect in animals, we initiated a pilot study of infraorbital TNS for epilepsy. Research committee approval was obtained for a pilot study of TNS. Inclusion criteria were age of 18 to 65 years, four or more complex partial seizures (CPS) or secondarily generalized seizures per month, no significant cardiac or medical conditions, EEG demonstrating focal epileptic discharges, ability to maintain accurate seizure calendars, no Trigeminal neuralgia, …

Richard F Schmidt - One of the best experts on this subject based on the ideXlab platform.

  • malignant peripheral Nerve sheath tumors of the Trigeminal Nerve a systematic review of 36 cases
    Neurosurgical Focus, 2013
    Co-Authors: Richard F Schmidt, Frederick Yick, Zain Boghani, Jean Anderson Eloy, James K Liu
    Abstract:

    Object Malignant peripheral Nerve sheath tumors (MPNSTs) are a rare form of malignancy arising from the Schwann cells of peripheral Nerves. MPNSTs of the Trigeminal Nerve are exceptionally rare, with only a handful of reports in the literature. These tumors are typically very aggressive, resulting in significant patient morbidity and a generally grim prognosis. Most current reports suggest that radical resection with radiation therapy offers the best benefit. In this study, the authors systematically reviewed the world English-language literature on MPNSTs of the Trigeminal Nerve to analyze the presentations, treatment options, and outcomes for patients with this disease. Methods A literature search for MPNSTs of the Trigeminal Nerve confined to nonanimal, English-language articles was conducted utilizing the PubMed database, with additional cases chosen from the references of selected articles. Only cases of confirmed MPNSTs of the Trigeminal Nerve or its peripheral branches, based upon surgical, patholo...

Christopher M. Degiorgio - One of the best experts on this subject based on the ideXlab platform.

  • pilot study of Trigeminal Nerve stimulation tns for epilepsy a proof of concept trial
    Epilepsia, 2006
    Co-Authors: Christopher M. Degiorgio, Alan Shewmon, Diane Murray, Todd Whitehurst
    Abstract:

    Summary: The safety and preliminary efficacy of Trigeminal Nerve stimulation (TNS) for epilepsy was evaluated in a pilot feasibility study of transcutaneous stimulation of the infraorbital and supraorbital branches of the Trigeminal Nerve. TNS was well tolerated. Four (57%) of seven subjects who completed ≥3 months experienced a ≥50% reduction in seizure frequency. The results of this pilot study support further investigation into the safety and efficacy of TNS for epilepsy. Key Words: Trigeminal Nerve stimulation—Epilepsy—Neurostimulation.

  • Trigeminal Nerve stimulation for epilepsy.
    Neurology, 2003
    Co-Authors: Christopher M. Degiorgio, D. Alan Shewmon, Todd Whitehurst
    Abstract:

    Epilepsy in many patients remains poorly controlled despite the introduction of new antiepileptic drugs (AEDs).1 Neurostimulation, including vagus Nerve stimulation (VNS), is a promising alternative to AEDs.2 The mechanism of VNS involves the locus ceruleus (LC) and nucleus solitarius (NTS).3,4⇓ As the LC and NTS project to the Trigeminal nucleus, stimulation of the Trigeminal Nerve may also activate similar pathways to VNS.4-6⇓⇓ The Trigeminal Nerve, via cutaneous branches, offers a noninvasive method of neurostimulation. Recently, infraorbital Trigeminal Nerve stimulation (TNS) reduced pentylenetetrazol-induced seizures in rats.7 Given the potent antiepileptic effect in animals, we initiated a pilot study of infraorbital TNS for epilepsy. Research committee approval was obtained for a pilot study of TNS. Inclusion criteria were age of 18 to 65 years, four or more complex partial seizures (CPS) or secondarily generalized seizures per month, no significant cardiac or medical conditions, EEG demonstrating focal epileptic discharges, ability to maintain accurate seizure calendars, no Trigeminal neuralgia, …