1/18. 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 = ganglion (Clic here for more details about this article) |
2/18. Relief of pain in acute herpes zoster by nerve blocks and possible prevention of post-herpetic neuralgia.PURPOSE: This report describes two cases of acute herpes zoster (AHZ) treated by nerve block resulting in immediate pain relief and possible prevention of post-herpetic neuralgia (PHN). CLINICAL FEATURES: Two elderly females with AHZ of cervical dermatomes and severe pain received deep cervical and greater occipital nerve blocks with a local anesthetic, epinephrine and steroid. In both patients, pain resolved immediately and permanently (one year follow-up) after a single treatment.Case #1: A 79-yr-old female with a mechanical mitral valve and anticoagulated with warfarin presented with AHZ of 17 days duration of the right C2, 3, 4 dermatomes and severe pain. A stellate ganglion block was not performed because of anticoagulation. Rather, a deep cervical root block at C3 and a greater occipital nerve block were performed with bupivacaine, epinephrine and methylprednisolone. No adverse events were evident. Case #2: A 73-yr-old female with a history of osteoarthritis and Meniere's disease presented with AHZ of seven days duration of the left C2, 3, 4 dermatomes and severe pain. Deep cervical root blocks at C3 and C4 and a greater occipital nerve block were performed with bupivacaine, epinephrine and methylprednisolone. Side effects of dizziness, hoarseness, hypertension and Horner's syndrome resolved in a few hours. A mild sensation of itching persisted for two weeks. CONCLUSION: This report illustrates the potential of nerve blocks in severe AHZ to treat acute pain and possibly prevent PHN.- - - - - - - - - - ranking = 0.5keywords = ganglion (Clic here for more details about this article) |
3/18. Retrograde adriamycin sensory ganglionectomy: novel approach for the treatment of intractable pain.Selective sensory ganglionectomy by means of retrograde suicide transport of adriamycin was performed on 3 patients with neuropathic pain in the areas of the trigeminal and intercostal nerves, producing significant pain relief, particularly from hyperalgesic pain. Adriamycin ganglionectomy is considered as a less invasive and highly selective pain treatment, which may possibly become an alternative for surgical ganglionectomy or rhizotomy.- - - - - - - - - - ranking = 3.5keywords = ganglion (Clic here for more details about this article) |
4/18. Post-herpetic neuralgia: further post-mortem studies of cases with and without pain.The pathological features associated with post-herpetic neuralgia require further study. We report here 5 cases, 3 with severe post-herpetic neuralgia (PHN) and 2 with no persistent pain. The findings of dorsal horn atrophy and cell, axon and myelin loss with fibrosis in the sensory ganglion were found only in patients with persistent pain. Marked loss of myelin and axons in the nerve and/or sensory root were found in cases with and without pain. Some evidence is presented for a more generalized subacute or chronic inflammatory process which may explain the clinical features of some patients. Further studies will be necessary to fully describe the morbid anatomy of this disorder.- - - - - - - - - - ranking = 0.5keywords = ganglion (Clic here for more details about this article) |
5/18. T2-ganglionectomy via limited costotransversectomy for minor causalgia.T2-ganglionectomy via limited costotransversectomy is a safe and effective method to produce sympathetic denervation of the upper extremity. It provides prompt and lasting relief of the complex array of symptoms associated with minor causalgia. Four patients with minor causalgia treated by this procedure are presented. All patients were seen by multiple physicians before a correct diagnosis was made. Pain and trophic changes resolved in all cases. No instances of Horner's syndrome or pneumothorax were encountered. Preoperative response to temporary stellate ganglion block is essential to both diagnosis and treatment. Consideration of early surgical intervention should be given in cases involving significant disability. A fundamental problem surrounding the appropriate management of minor causalgia has been and continues to be accurate recognition of the diagnosis.- - - - - - - - - - ranking = 3keywords = ganglion (Clic here for more details about this article) |
6/18. Treatment of chronic pain syndromes with transcutaneous iontophoresis of vinca alkaloids, with special regard to post-herpetic neuralgia.Successful treatment of 35 post-herpetic neuralgia (PHN) patients by means of transcutaneous iontophoresis of vincristine is reported. This technique, based on transganglionic regulation--a novel neurobiological principle discovered by Csillik and Knyihar-Csillik-, alleviated pain in both fresh and inveterated PHN cases. Statistical analysis of the results excludes a placebo-like action.- - - - - - - - - - ranking = 0.5keywords = ganglion (Clic here for more details about this article) |
7/18. Post-herpetic neuralgia: post-mortem analysis of a case.The morphological and biochemical substrates of the severe pain in post-herpetic neuralgia (PHN) are unclear. This report is an autopsy study of a 67-year-old male with severe PHN during the last 5 years of his life over the right T7-8 dermatomes. The dorsal horn of the thoracic spinal cord of the affected side was atrophic from T4 to T8, with loss of both myelin and axons. Despite this, only the T8 ganglion was affected by fibrosis and cell loss and only the nerve roots at that level appeared affected. Markers of unmyelinated afferents (substance p), substantia gelatinosa neurons (opiate receptors), glial cells (glial fibrillary acidic protein), and descending spinal projections (dopamine-beta-hydroxylase and serotonin) were not different at affected versus non-affected spinal cord levels. The pain of PHN may result from the uninhibited activity of unmyelinated primary afferents as a result of the loss of myelinated afferent fibers and the possible presence of hypersensitive neurons in the dorsal horn.- - - - - - - - - - ranking = 0.5keywords = ganglion (Clic here for more details about this article) |
8/18. Intercostal neuralgia following stellate ganglion block. An infrequent complication.The case is described of a 78-year-old female patient who experienced temporary but severe chest wall pain following stellate ganglion block. The possible mechanisms and treatment of this complication are discussed.- - - - - - - - - - ranking = 2.5keywords = ganglion (Clic here for more details about this article) |
9/18. Percutaneous radio-frequency thermocoagulation with low temperature in the treatment of essential glossopharyngeal neuralgia.Two cases of essential glossopharyngeal neuralgia treated successfully with percutaneous radio-frequency thermocoagulation are reported. In order to avoid cardiovascular complications due to interference with the vagus nerve, a modification of the technique previously used is proposed. The modification used in the cases presented here consists in the use of lower temperature during a shorter time with four progressive steps controlled with electrical stimulation. A small-surface active electrode, exact location in the petrous ganglion, permanent stimulation control, and a smaller thermal lesion are the cardinal features of the technique used in the cases reported.- - - - - - - - - - ranking = 0.5keywords = ganglion (Clic here for more details about this article) |
10/18. Familial trigeminal and glossopharyngeal neuralgia.A family incorporating 2 interesting variants of trigeminal and glossopharyngeal neuralgia is presented. The familial occurrence of these cranial neuralgias spanning 3 generations is very unusual. In the case of glossopharyngeal neuralgia it has not been documented previously. Furthermore, the coincidence of trigeminal and glossopharyngeal neuralgia in the same person is quite exceptional, despite the anatomical contiguity of the sensory territories of the fifth and ninth cranial nerves. These features suggest firstly that there must be an important constitutional factor in the aetiology of the cranial neuralgia, and secondly that in many cases there is a centronuclear rather than cranial nerve ganglionic pathogenesis of the pain.- - - - - - - - - - ranking = 0.5keywords = ganglion (Clic here for more details about this article) |
| | Next -> |