Trigeminal Neuralgia and Other Facial Neuralgias.

Radiosurgery is an effective treatment approach for the management of type 1 trigeminal neuralgia (TN), comparable to other ablative techniques. Also, radiosurgery can effectively treat TN secondary to other causes, including multiple sclerosis, tumor-related TN, as well as other craniofacial neuralgias in select cases with minimal complications. An increasing number of patients favor radiosurgery over other more invasive approaches in order to avoid a general anesthetic, a prolonged hospital stay, and a higher risk of complications.

Bloqueo y radiofrecuencia del ganglio esfenopalatino para el tratamiento de algias faciales / No disponible

El ganglio esfenopalatino (GEFP), también llamado ganglio de Meckel, ganglio pterigopalatino y ganglio esfenomaxilar, es el mayor de los ganglios parasimpáticos extracraneales. Está íntimamente relacionado con múltiples estructuras faciales, interviniendo en la patogénesis y mantenimiento de dolores faciales (1). Fue Sluder quien en 1909 primero describió la neuralgia del ganglio esfenopalatino (2).En el siguiente artículo se describe la anatomía, las indicaciones, contraindicaciones, técnica y complicaciones para la realización del bloqueo diagnóstico y su neurolisis por radiofrecuencia (AU)

The (GEFP), also called Meckel´s ganglion, pterigopalatine ganglion and sphenomaxillary ganglion, is the largest of the peripheral parasympathetic ganglia. It has tightly interneuronal relationships with multiple facial structures, being involved in the pathogenesis of facial pain. Sphenopalatine neuralgia was originally described by Sluder in 1909. In this article, the anatomy, indications, contraindications, blocking technique, radiofrequency technique and complications are reviewed (AU)

Comparison of laser, dry needling, and placebo laser treatments in myofascial pain syndrome.

OBJECTIVE: We aimed to evaluate the effectiveness of laser therapy in myofascial pain syndrome treatment. BACKGROUND DATA: Myofascial pain syndrome is a disease that is characterized by hypersensitive points called trigger points found in one or more muscles and/or connective tissues. It can cause pain, muscle spasm, sensitivity, stiffness, weakness, limitation of range of motion and rarely autonomic dysfunction. Physical therapy modalities and exercise are used in the treatment of this frequently encountered disease. METHODS: The placebo controlled, prospective, long-term follow up study was planned with 60 patients who had trigger points in their upper trapezius muscles. The patients were divided into three groups randomly. Stretching exercises were taught to each group and they were asked to exercise at home. Treatment duration was 4 weeks. Placebo laser was applied to group 1, dry needling to group 2 and laser to group 3. He-Ne laser was applied to three trigger points in the upper trapezius muscles on both sides with 632.8 nm. The patients were assessed at before, post-treatment, and 6 months after-treatment for pain, cervical range of motion and functional status. RESULTS: We observed a significant decrease in pain at rest, at activity, and increase in pain threshold in the laser group compared to other groups. Improvement according to Nottingham Health Profile gave the superiority of the laser treatment. However, those differences among the groups were not observed at 6-month follow up. CONCLUSIONS: Laser therapy could be useful as a treatment modality in myofascial pain syndrome because of its noninvasiveness, ease, and short-term application.

[Low reactive-level laser therapy near the stellate ganglion for postherpetic facial neuralgia].

Low reactive-level laser therapy near the stellate ganglion was given for a 68-year-old female with postherpetic neuralgia, suffering from burning pain in the right forehead for 11 years. Stellate ganglion block and supraorbital nerve block with oral medication were not effective to relieve this pain. The laser irradiation induced warm sensation in her face followed by an excellent pain relief. Thermograms illustrated a remarkable increase from 30.6 degrees C to 31.5 degrees C in temperature of her right face. The irradiation near the right carotid artery also had the similar effect. The results imply that the irradiation with low reactive-level laser of the stellate ganglion and/or the carotid artery increases a facial blood flow and relieves facial neuralgia.