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Manoel Jacobsen Teixeira - One of the best experts on this subject based on the ideXlab platform.
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Management of Trigeminal Neuralgia in sclerosteosis.
Surgical neurology international, 2013Co-Authors: Emerson Magno De Andrade, André Beer-furlan, Kleber Paiva Duarte, Erich Talamoni Fonoff, Manoel Jacobsen TeixeiraAbstract:Sclerosteosis is a rare bone disorder characterized by a progressive craniotubular hyperostosis. The diagnosis of sclerosteosis is based on characteristic clinical and radiographic features and a family history consistent with autosomal recessive inheritance. The skull overgrowth may lead to lethal elevation of intracranial pressure, distortion of the face, and entrapment of cranial nerves, resulting in recurrent facial palsy or secondary Trigeminal Neuralgia. The authors reported cases of two siblings who were diagnosed with familial sclerosteosis and presented with secondary Trigeminal Neuralgia. The patients were 28 and 40-year-old and presented with pain in the right V2-V3 and V3 distributions, respectively. The facial pain was resistant to medications and was treated with percutaneous techniques. The foramen ovale puncture was complicated initially and the difficulty increased over the years due to stenosis of the foramen. The treatment of the Trigeminal Neuralgia secondary to hyperostosis and resistant to medications presents a dilemma. The narrowing of the foramen oval and difficulty in the identifying and approaching of the foramen makes the percutaneous technique a challenge for the neurosurgeon in patients harboring sclerosteosis. Microvascular decompression should not be considered since the primary cause of the Trigeminal Neuralgia is the nerve entrapment by the narrowing of neurovascular foramina and not the neurovascular conflict related to essential Trigeminal Neuralgia. Stereotactic radiosurgery may be a good treatment option, but there is a lack of published data supporting the use of this method in cranial hyperostosis.
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Management of Trigeminal Neuralgia in sclerosteosis.
Surgical Neurology International, 2013Co-Authors: Emerson Magno De Andrade, André Beer-furlan, Kleber Paiva Duarte, Erich Talamoni Fonoff, Manoel Jacobsen TeixeiraAbstract:Background: Sclerosteosis is a rare bone disorder characterized by a progressive craniotubular hyperostosis. The diagnosis of sclerosteosis is based on characteristic clinical and radiographic features and a family history consistent with autosomal recessive inheritance. The skull overgrowth may lead to lethal elevation of intracranial pressure, distortion of the face, and entrapment of cranial nerves, resulting in recurrent facial palsy or secondary Trigeminal Neuralgia. Cases Description: The authors reported cases of two siblings who were diagnosed with familial sclerosteosis and presented with secondary Trigeminal Neuralgia. The patients were 28 and 40-year-old and presented with pain in the right V2-V3 and V3 distributions, respectively. The facial pain was resistant to medications and was treated with percutaneous techniques. The foramen ovale puncture was complicated initially and the diffi culty increased over the years due to stenosis of the foramen. Conclusion: The treatment of the Trigeminal Neuralgia secondary to hyperostosis and resistant to medications presents a dilemma. The narrowing of the foramen oval and diffi culty in the identifying and approaching of the foramen makes the percutaneous technique a challenge for the neurosurgeon in patients harboring sclerosteosis. Microvascular decompression should not be considered since the primary cause of the Trigeminal Neuralgia is the nerve entrapment by the narrowing of neurovascular foramina and not the neurovascular confl ict related to essential Trigeminal Neuralgia. Stereotactic radiosurgery may be a good treatment option, but there is a lack of published data supporting the use of this method in cranial hyperostosis. This article may be cited as:
Vikram V. Nayar - One of the best experts on this subject based on the ideXlab platform.
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Update on Trigeminal Neuralgia
Current Treatment Options in Neurology, 2019Co-Authors: Vikram V. NayarAbstract:Purpose of review To review current treatments for Trigeminal Neuralgia, with an emphasis on determining which patients may benefit from neurosurgical procedures. Recent findings A detailed history is the most helpful tool for diagnosing Trigeminal Neuralgia (TN) and predicting response to neurosurgical treatments. Patients with classic Trigeminal Neuralgia will describe severe, unilateral, intermittent facial pain that is triggered by innocuous sensory stimuli. In most cases, pain is caused by compression of the Trigeminal nerve by a blood vessel near the brainstem. Magnetic resonance imaging is necessary to rule out TN secondary to multiple sclerosis or tumor. Modern high-resolution T2 images may demonstrate neurovascular contact, particularly when analyzed by a neurosurgeon with expertise in TN. Initial management involves a trial of medication, usually carbamazepine or oxcarbazepine. Microvascular decompression (MVD) is safe and effective surgery, for patients with classic TN related to neurovascular compression. For patients with TN secondary to multiple sclerosis, and for patients who are otherwise poor candidates for MVD, neurosurgical options include percutaneous Trigeminal rhizotomy and radiosurgery. Neurosurgical procedures are less effective in relieving atypical facial pain. Summary In the clinical evaluation of a patient with facial pain, it is important to distinguish classic Trigeminal Neuralgia from atypical facial pain. A patient with classic Trigeminal Neuralgia would benefit from neurosurgical consultation. The advent of high-resolution MRI and MRA sequences now allows a neurosurgeon to detect when neurovascular compression is likely, and select the optimal procedure for treatment.
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Update on Trigeminal Neuralgia
Current treatment options in neurology, 2019Co-Authors: Alexander X. Tai, Vikram V. NayarAbstract:To review current treatments for Trigeminal Neuralgia, with an emphasis on determining which patients may benefit from neurosurgical procedures. A detailed history is the most helpful tool for diagnosing Trigeminal Neuralgia (TN) and predicting response to neurosurgical treatments. Patients with classic Trigeminal Neuralgia will describe severe, unilateral, intermittent facial pain that is triggered by innocuous sensory stimuli. In most cases, pain is caused by compression of the Trigeminal nerve by a blood vessel near the brainstem. Magnetic resonance imaging is necessary to rule out TN secondary to multiple sclerosis or tumor. Modern high-resolution T2 images may demonstrate neurovascular contact, particularly when analyzed by a neurosurgeon with expertise in TN. Initial management involves a trial of medication, usually carbamazepine or oxcarbazepine. Microvascular decompression (MVD) is safe and effective surgery, for patients with classic TN related to neurovascular compression. For patients with TN secondary to multiple sclerosis, and for patients who are otherwise poor candidates for MVD, neurosurgical options include percutaneous Trigeminal rhizotomy and radiosurgery. Neurosurgical procedures are less effective in relieving atypical facial pain. In the clinical evaluation of a patient with facial pain, it is important to distinguish classic Trigeminal Neuralgia from atypical facial pain. A patient with classic Trigeminal Neuralgia would benefit from neurosurgical consultation. The advent of high-resolution MRI and MRA sequences now allows a neurosurgeon to detect when neurovascular compression is likely, and select the optimal procedure for treatment.
Emerson Magno De Andrade - One of the best experts on this subject based on the ideXlab platform.
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Management of Trigeminal Neuralgia in sclerosteosis.
Surgical neurology international, 2013Co-Authors: Emerson Magno De Andrade, André Beer-furlan, Kleber Paiva Duarte, Erich Talamoni Fonoff, Manoel Jacobsen TeixeiraAbstract:Sclerosteosis is a rare bone disorder characterized by a progressive craniotubular hyperostosis. The diagnosis of sclerosteosis is based on characteristic clinical and radiographic features and a family history consistent with autosomal recessive inheritance. The skull overgrowth may lead to lethal elevation of intracranial pressure, distortion of the face, and entrapment of cranial nerves, resulting in recurrent facial palsy or secondary Trigeminal Neuralgia. The authors reported cases of two siblings who were diagnosed with familial sclerosteosis and presented with secondary Trigeminal Neuralgia. The patients were 28 and 40-year-old and presented with pain in the right V2-V3 and V3 distributions, respectively. The facial pain was resistant to medications and was treated with percutaneous techniques. The foramen ovale puncture was complicated initially and the difficulty increased over the years due to stenosis of the foramen. The treatment of the Trigeminal Neuralgia secondary to hyperostosis and resistant to medications presents a dilemma. The narrowing of the foramen oval and difficulty in the identifying and approaching of the foramen makes the percutaneous technique a challenge for the neurosurgeon in patients harboring sclerosteosis. Microvascular decompression should not be considered since the primary cause of the Trigeminal Neuralgia is the nerve entrapment by the narrowing of neurovascular foramina and not the neurovascular conflict related to essential Trigeminal Neuralgia. Stereotactic radiosurgery may be a good treatment option, but there is a lack of published data supporting the use of this method in cranial hyperostosis.
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Management of Trigeminal Neuralgia in sclerosteosis.
Surgical Neurology International, 2013Co-Authors: Emerson Magno De Andrade, André Beer-furlan, Kleber Paiva Duarte, Erich Talamoni Fonoff, Manoel Jacobsen TeixeiraAbstract:Background: Sclerosteosis is a rare bone disorder characterized by a progressive craniotubular hyperostosis. The diagnosis of sclerosteosis is based on characteristic clinical and radiographic features and a family history consistent with autosomal recessive inheritance. The skull overgrowth may lead to lethal elevation of intracranial pressure, distortion of the face, and entrapment of cranial nerves, resulting in recurrent facial palsy or secondary Trigeminal Neuralgia. Cases Description: The authors reported cases of two siblings who were diagnosed with familial sclerosteosis and presented with secondary Trigeminal Neuralgia. The patients were 28 and 40-year-old and presented with pain in the right V2-V3 and V3 distributions, respectively. The facial pain was resistant to medications and was treated with percutaneous techniques. The foramen ovale puncture was complicated initially and the diffi culty increased over the years due to stenosis of the foramen. Conclusion: The treatment of the Trigeminal Neuralgia secondary to hyperostosis and resistant to medications presents a dilemma. The narrowing of the foramen oval and diffi culty in the identifying and approaching of the foramen makes the percutaneous technique a challenge for the neurosurgeon in patients harboring sclerosteosis. Microvascular decompression should not be considered since the primary cause of the Trigeminal Neuralgia is the nerve entrapment by the narrowing of neurovascular foramina and not the neurovascular confl ict related to essential Trigeminal Neuralgia. Stereotactic radiosurgery may be a good treatment option, but there is a lack of published data supporting the use of this method in cranial hyperostosis. This article may be cited as:
Elijah W. Stommel - One of the best experts on this subject based on the ideXlab platform.
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Familial Trigeminal Neuralgia: case reports and review of the literature.
Headache, 2003Co-Authors: Paul G. Smyth, Glen Greenough, Elijah W. StommelAbstract:The paroxysmal facial pain of Trigeminal Neuralgia is usually idiopathic, but familial cases have been described. We describe a family with apparent autosomal dominant transmission of Trigeminal Neuralgia. Our cases and a review of the literature suggest that the etiology of Trigeminal Neuralgia may be vascular compression of the fifth cranial nerve. Autosomal dominant vascular and epileptic disorders are reviewed, and possible relationships to familial Trigeminal Neuralgia are considered.
W S Metzer - One of the best experts on this subject based on the ideXlab platform.
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Trigeminal Neuralgia secondary to tumor with normal exam, responsive to carbamazepine
Headache, 1991Co-Authors: W S MetzerAbstract:Trigeminal Neuralgia is most commonly idiopathic, although it can be associated with multiple sclerosis. Tumors are rare causes of Trigeminal Neuralgia. A case is presented of Trigeminal Neuralgia with normal neurological examination and responsive to carbamazepine, secondary to a cerebellopontine angle meningioma. Literature relative to neoplastic etiologies of Trigeminal Neuralgia is reviewed. The role of electrodiagnostic testing in the evaluation of Trigeminal Neuralgia is considered. A normal neurological examination and responsiveness to carbamazepine do not exclude tumor as an etiology of Trigeminal Neuralgia.
