1/7. Reversible central pain.We report two cases of central pain which receded completely after treatment of the inciting lesion. These cases highlight the intrinsic reversibility of central pain and the focal nature of central pain mechanisms.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/7. Geniculate neuralgia: long-term results of surgical treatment.A rare cause of otalgia is geniculate neuralgia. In its most typical form, it is characterized by severe paroxysmal neuralgic pain centered directly in the ear. The pain can be of a gradual onset and of a dull, persistent nature, but occasionally it is sharp and stabbing. When the pain becomes intractable, an operation to surgically excise the nervus intermedius and geniculate ganglion via the middle cranial fossa approach is indicated. The purpose of this article is to review the long-term outcomes in 64 patients who were treated in this manner. Findings indicate that excision of the nervus intermedius and geniculate ganglion can be routinely performed without causing facial paralysis and that it is an effective definitive treatment for intractable geniculate neuralgia.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/7. Disappearance of central pain following iatrogenic stroke.An exceptional case of long-standing central pain temporarily relieved by a focal stroke in the primary somatosensory area is reported. This case highlights the focal nature of central pain mechanisms and the possible value of selective subparietal leukotomies in the management of central pain.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/7. Surgical treatment of trigeminal neuralgia.trigeminal neuralgia, which is unilateral electric shock or knifelike pain occurring in one or more branches of the trigeminal nerve, is evoked by stimulation of the face, lips, or gums caused by activities such as shaving, brushing the teeth, or moving trigger zones. IT GENERALLY IS ACCEPTED that classic trigeminal neuralgia is a consequence of vascular compression and demyelination of the trigeminal nerve. Although medical therapy is available, it gradually becomes less effective because of the progressive nature of trigeminal neuralgia. MICROVASCULAR decompression of the trigeminal nerve to treat trigeminal neuralgia is discussed in this article. perioperative care, expected course of recovery, and potential complications are described.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/7. Short-lasting unilateral neuralgiform headache attacks with conjunctival injection, tearing, etc. (SUNCT): III. Another Norwegian case."SUNCT" is a recently reported head pain syndrome characterized by shortlasting, unilateral neuralgiform paroxysms with conjunctival injection and tearing, and to a lesser extent nasal secretion, and (subclinical) sweating. Another case--that of a 56 year old male--is reported herein. The attacks lasted 1/2-1 min. and occurred only infrequently, i.e. once or twice in 1-4 weeks, except for a week recently when there were up to 20 or more typical attacks per day, with the usual ipsilateral, autonomic accompaniments. Due to the benign nature and low frequency of attacks, the diagnosis would have been most difficult to establish prior to the occurrence of this shortlasting period with more marked symptoms. A variety of precipitation mechanisms were present, partly concerning the V 2-3 areas, partly concerning the neck. Precipitation mechanisms in "SUNCT" to some extent seem to differ from those in trigeminal neuralgia. It is remarkable that all four hitherto reported cases are males.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/7. An electroencephalographic study of glossopharyngeal neuralgia with syncope.In the case described, electroencephalography (EEG) proved valuable for determining the nature of spells of loss of consciousness with brief clonic jerks associated with ear and throat pain. A 70-year-old woman had a history of episodic brief attacks of pain below the right ear and deep in the neck that had started three years previously. The spells became more severe and progressed to loss of awareness associated with clonic jerks of the extremities. Because of a concern that the spells represented seizures, an EEG was performed, with electrocardiographic monitoring. Multiple spells were recorded; they began with profound bradycardia followed by generalized slow-wave activity and then by suppression of all EEG activity correlating with loss of consciousness and clonic jerking. The spells were thought to represent syncopal attacks associated with glossopharyngeal neuralgia.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/7. Geniculate neuralgia: diagnosis and surgical management.pain in the ear is a common complaint for which patients consult their otolaryngologist. A rare cause is geniculate neuralgia, which has also been called tic douloureux of the nervus intermedius. In its most typical form, it is characterized by severe paroxysmal neuralgic pain centered directly in the ear. The pain may also be of gradual onset and of a dull, persistent nature, with occasional sharp, stabbing pain. The diagnostic features and two new surgical techniques for its treatment are described. Afferent sensory facial nerve fibers are shown to pass not only through the nervus intermedius, but also through the main motor trunk of the facial nerve. Excision of the nervus intermedius and/or of the geniculate ganglion by the middle cranial fossa approach without the production of facial paralysis, in any of 15 cases with geniculate neuralgia is reported. Use of these new techniques, sometimes in combination with selective section of the Vth cranial nerve, has been successful in relieving the pain of geniculate neuralgia.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |