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1.
Headache ; 61(3): 560-562, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33749854

RESUMO

OBJECTIVE: To describe a case report of trigeminal neuralgia (TN) due to coronavirus disease-2019 (COVID-19). BACKGROUND: In March 2020, the World Health Organization declared COVID-19 as a pandemic. Respiratory system manifestations are dominant in this new disease. However, numerous case series and reviews have been published on the neurological manifestations, highlighting the potential neurotropism of the new coronavirus. METHODS: We describe a clinical case of TN during COVID-19 and we discuss the differential diagnosis and the potential pathogenic mechanism according to the literature. RESULTS: A 65-year-old man with general malaise and typical respiratory symptoms of COVID-19, who presented with paroxysmal lancinating pain in the right V1 trigeminal territory without other neurological symptoms. General blood test and neuroimaging study were normal. A rapid test showed positive IgG and IgM serologies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The patient was diagnosed with TN secondary to a viral infection by SARS-CoV-2. Facial pain resolved with the improvement of COVID-19. CONCLUSIONS: The new coronavirus SARS-CoV-2 is a possible etiology of secondary TN. Nevertheless, more studies are needed to elucidate the neuropathology of this viral infection.


Assuntos
COVID-19/complicações , Neuralgia do Trigêmeo/virologia , Idoso , Humanos , Masculino , SARS-CoV-2
2.
World Neurosurg ; 141: 284-290, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32450307

RESUMO

BACKGROUND: Primary intracranial leiomyoma is a rare smooth muscle tumor often associated with Epstein-Barr virus (EBV), with <30 cases reported worldwide. These tumors commonly occur in patients with immunocompromised status, especially those with human immunodeficiency virus. In the present report, we have described the case of an EBV-associated leiomyoma at the cerebellopontine angle. The patient had presented with trigeminal neuralgia, which, to the best of our knowledge, is the first reported anatomical location and presentation for this tumor type. CASE DESCRIPTION: A 41-year-old male patient had presented with right-sided facial pain in the V1 and V2 dermatomes and previous workup and imaging studies. The patient had undergone treatment of a presumed right-side cerebellopontine angle meningioma as determined by the magnetic resonance imaging characteristics (no biopsy). The patient subsequently underwent right-sided retrosigmoid craniotomy and gross total resection of the tumor. The postoperative period was uneventful with resolution of the trigeminal neuralgia. Histopathologic examination revealed spindle cell neoplasm with histopathologic and immunohistochemical features consistent with leiomyoma. The tumor cells were positive for smooth muscle actin and desmin and were negative for S100, SOX-10, epithelial membrane antigen, glial fibrillary acidic protein, progesterone receptor, CD31, CD34, and E-cadherin. CONCLUSIONS: Primary intracranial leiomyomas are rare tumors associated with EBV infection that occur in immunocompromised patients. These lesions should be considered in the differential diagnosis for patients with known immunocompromised status (e.g., human immunodeficiency virus), and tissue biopsy should be considered.


Assuntos
Encéfalo/virologia , Ângulo Cerebelopontino/cirurgia , Infecções por Vírus Epstein-Barr/cirurgia , Leiomioma/virologia , Neuralgia do Trigêmeo/cirurgia , Adulto , Encéfalo/cirurgia , Ângulo Cerebelopontino/virologia , Craniotomia/métodos , Diagnóstico Diferencial , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/diagnóstico , Humanos , Leiomioma/diagnóstico , Leiomioma/cirurgia , Masculino , Neuroma Acústico/cirurgia , Neuralgia do Trigêmeo/virologia
3.
Pain Physician ; 22(4): 361-368, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31337167

RESUMO

BACKGROUND: Trigeminal postherpetic neuralgia is a severe neuropathic pain and often refractory to existing treatment, it develops secondary to herpes zoster-infected Gasserian ganglion. Therefore, it is important to prevent the transition of acute/subacute zoster-related pain to trigeminal postherpetic neuralgia. Despite numerous studies, the optimal intervention that reduces trigeminal postherpetic neuralgia incidence is still unknown. OBJECTIVES: This study aimed to evaluate the efficacy and safety of high-voltage, long-duration pulsed radiofrequency (PRF) on the Gasserian ganglion in patients with acute/subacute zoster-related trigeminal neuralgia. STUDY DESIGN: Prospective, randomized, double-blinded study. SETTING: Department of Pain Medicine, the First Affiliated Hospital of China Medical University. METHODS: Ninety-six patients with acute/subacute zoster-related trigeminal neuralgia were equally randomly assigned into 2 groups. The electrode needle punctured the Gasserian ganglion guided by computed tomography in every patient. High-voltage, long-duration PRF at 42°C for 900 seconds was applied in the PRF group (n = 48). It was also applied in the sham group (n = 48) without radiofrequency energy output. The therapeutic effects were evaluated using a visual analog scale (VAS) and the 36-Item Short Form Health Survey (SF-36) at different time points. The average dosage of pregabalin (mg/d) administrated within the first month after treatment was also recorded. RESULTS: The postprocedure VAS scores in the PRF group were significantly lower than those in the sham group at different time points after treatment (P < 0.01). The SF-36 scores, which included physical functioning, physical role, bodily pain, general health perceptions, vitality, social function, emotional role, and the mental health index, were significantly improved at the sixth month after treatment in the PRF group compared with the sham group (P < 0.01). The average dosage of pregabalin administered (mg/d) within the first month after treatment was also significantly reduced in the PRF group compared with the sham group (P < 0.01). There were no bleeding, infection, or other severe side effects in both groups. LIMITATIONS: Single center study, relatively small number of patients. CONCLUSIONS: High-voltage, long-duration PRF on the Gasserian ganglion is an effective and safe therapeutic alternative for patients with acute/subacute zoster-related trigeminal neuralgia. KEY WORDS: Pulsed radiofrequency, zoster-related trigeminal neuralgia, visual analog scale, 36-Item Short Form Health Survey.


Assuntos
Neuralgia Pós-Herpética/terapia , Manejo da Dor/métodos , Tratamento por Radiofrequência Pulsada/métodos , Neuralgia do Trigêmeo/terapia , Idoso , China , Método Duplo-Cego , Feminino , Herpes Zoster , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Gânglio Trigeminal , Neuralgia do Trigêmeo/virologia
4.
Medicine (Baltimore) ; 97(38): e12388, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30235706

RESUMO

RATIONALE: Effective treatments for trigeminal nerve postherpetic neuralgia (PHN) are limited. Adriamycin (doxorubicin) has been applied to the treatment of neuropathic pain. This study reports a new treatment: Adriamycin injected to Gasserian ganglion for an elderly patient with the intractable trigeminal nerve PHN. PATIENT CONCERNS: A 75-year-old man complained of lancing, burning pain in the right mandibular branch of the trigeminal nerve (V3) for 3 months after rash eruption. DIAGNOSES: Trigeminal nerve PHN. INTERVENTIONS: Approximately 0.5 mL of 0.25% Adriamycin and 20 mg methylprednisolone injected to Gasserian ganglion through the foramen ovale with computer tomography guidance. OUTCOMES: The visual analog scale was 10 of 100 throughout the 1-month follow-up, and oxcarbazepine had also been tapered. The patient remained free of pain at the 12-month follow-up. LESSONS: The treatment of Adriamycin injection to Gasserian ganglion is effective and safe, and may be considered as an alternative treatment for trigeminal nerve PHN. However, more research is needed to verify the validity.


Assuntos
Antibióticos Antineoplásicos/administração & dosagem , Doxorrubicina/administração & dosagem , Neuralgia Pós-Herpética/tratamento farmacológico , Neuralgia do Trigêmeo/tratamento farmacológico , Idoso , Humanos , Injeções , Masculino , Gânglio Trigeminal , Neuralgia do Trigêmeo/virologia
7.
World Neurosurg ; 84(2): 279-82, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25818891

RESUMO

Common to the types of surgery that are effective for the treatment of trigeminal neuralgia (TN) is reactivation of herpes simplex virus (HSV). It is likely that such HSV reactivation following surgery indicates altered trigeminal ganglion neuron function, which was caused by the surgery. It is not thought that HSV infection is related to the cause of TN or that HSV reactivation is important for surgical treatment efficacy. Rather, it is thought that HSV reactivation is a marker of altered trigeminal ganglion neuron function resulting from the TN surgery. It is suggested that HSV reactivation is a surrogate marker of ganglion neuron injury. The correlation between effective types of surgery and evidence that they alter ganglion neuron function suggests that altered trigeminal ganglion neuron function may be the basis of the surgical efficacy.


Assuntos
Herpes Simples/etiologia , Simplexvirus/fisiologia , Neuralgia do Trigêmeo/cirurgia , Neuralgia do Trigêmeo/virologia , Ativação Viral , Humanos , Gânglio Trigeminal/fisiopatologia , Latência Viral
8.
Indian J Dent Res ; 24(3): 396, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24025898

RESUMO

Herpes zoster is an uncommon acute viral infection caused by reactivation of varicella zoster virus. During the prodromal stage, the only presenting symptom may be odontalgia, which may prove to be a diagnostic challenge for the dentist. Practicing dentist may carry out emergency treatment that might result in irreversible damage or may delay the appropriate treatment. With an ever-increasing number of elderly and immunocompromised patients reporting to the dentist, the dental profession can expect to encounter an increased number of herpes zoster patients. Dentist must be familiar with the presenting signs and symptoms of patients experiencing the prodromal manifestations of herpes zoster of the trigeminal nerve. This article focuses on the difficulties in management of such cases, and one such case is reported here.


Assuntos
Herpes Zoster/complicações , Herpes Zoster/diagnóstico , Neuralgia do Trigêmeo/diagnóstico , Neuralgia do Trigêmeo/virologia , Aciclovir/uso terapêutico , Idoso , Antivirais/uso terapêutico , Diagnóstico Diferencial , Herpes Zoster/tratamento farmacológico , Humanos , Masculino , Nervo Trigêmeo , Neuralgia do Trigêmeo/tratamento farmacológico
9.
Pediatr Neurol ; 49(3): 205-8, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23838411

RESUMO

BACKGROUND: Varicella zoster virus primary infection is responsible for chickenpox, whereas secondary infection or reactivation can lead to a variety of clinical scenarios. If latent infection is established in trigeminal ganglion, the reactivation can determine viral migration to cerebral arteries, which causes a cerebral vasculopathy and subsequently an ischemic stroke. PATIENTS: Here we report on a child experiencing recurrent episodes of headache mimicking a trigeminal autonomic cephalalgia, in the absence of any skin rash, which were followed by the occurrence of an ipsilateral hemiparesis associated with a choreic movement disorder a month later. RESULTS: Magnetic resonance angiography showed evidence of a right-sided infarction of basal ganglia and anterior limb of the internal capsule, corresponding to the vascular territory of the recurrent artery of Heubner, as a consequence of a focal varicella zoster virus arteriopathy. CONCLUSIONS: We suggest that the recognition of this prodromal manifestation, which can be interpreted as a zoster sine herpete, could provide clinicians an extremely useful time window to start promptly with a prophylactic treatment.


Assuntos
Coreia/etiologia , Herpesvirus Humano 3/patogenicidade , Neuralgia do Trigêmeo/etiologia , Zoster Sine Herpete/complicações , Pré-Escolar , Coreia/virologia , Feminino , Humanos , Angiografia por Ressonância Magnética , Imageamento por Ressonância Magnética , Neuralgia do Trigêmeo/virologia
10.
Gen Dent ; 56(6): 563-6; quiz 567-8, 591-2, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18810918

RESUMO

Herpes zoster (HZ, also known as shingles) is caused by the reactivation of a dormant varicella zoster virus and can be a source of significant morbidity. Oral manifestations can include vesicular eruptions of the mucosa, osteonecrosis with tooth loss, and postherpetic neuralgia (PHN). This article discusses treatment for trigeminal nerve involvement with herpes zoster, as well as for the painful syndrome PHN.


Assuntos
Herpes Zoster/prevenção & controle , Doenças da Boca/virologia , Neuralgia Pós-Herpética/prevenção & controle , Osteonecrose/virologia , Neuralgia do Trigêmeo/virologia , Idoso , Idoso de 80 Anos ou mais , Antivirais/uso terapêutico , Herpes Zoster/complicações , Herpes Zoster/terapia , Vacina contra Herpes Zoster/uso terapêutico , Humanos , Doenças Maxilomandibulares/prevenção & controle , Doenças Maxilomandibulares/terapia , Doenças Maxilomandibulares/virologia , Masculino , Pessoa de Meia-Idade , Doenças da Boca/etiologia , Doenças da Boca/terapia , Neuralgia Pós-Herpética/terapia , Neuralgia Pós-Herpética/virologia , Osteonecrose/prevenção & controle , Osteonecrose/terapia , Neuralgia do Trigêmeo/prevenção & controle , Neuralgia do Trigêmeo/terapia
11.
Childs Nerv Syst ; 24(6): 763-6, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18293001

RESUMO

CASE REPORT: We present the case of an 11-year-old boy who was suffering distinct trigeminal neuralgia. At the age of 3 years, the patient had contracted a severe Epstein-Barr virus infection and developed mild meningoencephalitis. Magnetic resonance imaging scans showed a slight enhancement in the pontomesencephalic cistern as well as a neurovascular conflict at the right trigeminal nerve. Intraoperatively, thickened fibrous tissue was found that was attached to both the trigeminal nerve and the superior cerebellar artery. Microvascular decompression using Gore Tex as tissue implant brought immediate relief. DISCUSSION: Trigeminal neuralgia in pediatric patients is very rare. We present a case of typical trigeminal neuralgia in a child, demonstrating the pathogenesis of the neurovascular conflict due to subarachnoidal adhesions after meningoencephalitis.


Assuntos
Descompressão Cirúrgica/métodos , Microcirculação/cirurgia , Neuralgia do Trigêmeo/cirurgia , Criança , Humanos , Angiografia por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/métodos , Masculino , Microcirculação/patologia , Neuralgia do Trigêmeo/etiologia , Neuralgia do Trigêmeo/virologia
13.
J Oral Pathol Med ; 36(6): 347-50, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17559496

RESUMO

BACKGROUND: Post-herpetic neuralgia (PHN) is one complication after herpes zoster infection, which may affect the facial superficial sensitivity. METHODS: Eighteen patients with PHN were interviewed and evaluated according to a systematized sensitivity approach, including mechanical, thermal and pain. RESULTS: The pain location was V1 in 15 patients. All trigeminal branches from both facial sides were evaluated; we compared the affected with the opposite side. There was a significant difference at V1 with cold (P=0.038), vonFrey (P=0.008) and pinpricks (P=0.022); at V2, the statistical difference occurred with cold (P=0.034), heat (P=0.019) and pinpricks (P=0.037); at V3, differences occurred with cold (P=0.042) and heat (P=0.036). Only V1 and oral mucosa (V2-3) presented pain threshold differences between both sides (P=0.001, P=0.021). CONCLUSION: Age, predominance of trigeminal PHN in V1 and continuous burning pain was common and similar to literature. Sensation was hampered with evident deficits of all sensory modalities in the affected trigeminal areas, especially V1.


Assuntos
Face/inervação , Neuralgia Pós-Herpética/fisiopatologia , Neuralgia do Trigêmeo/fisiopatologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Herpesvirus Humano 3 , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nervo Oftálmico/fisiopatologia , Nervo Oftálmico/virologia , Medição da Dor , Estatísticas não Paramétricas , Fatores de Tempo , Neuralgia do Trigêmeo/virologia
14.
Br J Neurosurg ; 20(6): 423-6, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17439097

RESUMO

A patient developed herpes zoster of the maxillary division of the trigeminal nerve after microvascular decompression. Varicella zoster virus lies dormant in the Gasserian ganglion until reactivation and can cause herpes zoster ophthalmicus. This can result in serious ocular complications including blindness. Antiviral agents are effective if commenced promptly.


Assuntos
Herpes Zoster , Nervo Trigêmeo/virologia , Neuralgia do Trigêmeo/virologia , Aciclovir/uso terapêutico , Idoso , Antivirais/uso terapêutico , Descompressão Cirúrgica , Herpes Zoster/diagnóstico , Herpes Zoster/terapia , Humanos , Masculino , Resultado do Tratamento , Neuralgia do Trigêmeo/complicações , Neuralgia do Trigêmeo/cirurgia
15.
J Neurosurg ; 102 Suppl: 276-82, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15662825

RESUMO

OBJECT: The authors tested the hypothesis that two targets are needed to treat postherpetic trigeminal neuralgia (TN): one in the trigeminal nerve for the direct sharp pain and one in the thalamus for the diffuse burning pain. METHODS: Three patients with refractory postherpetic TN were treated with gamma knife surgery (GKS) through a novel two-target approach. In a single treatment session, both the trigeminal nerve and centromedian nucleus were targeted. First, the trigeminal nerve, ipsilateral to the facial pain, was treated with 60 to 80 Gy. Second, the centromedian nucleus was localized using standard coordinates and by comparing magnetic resonance images with a stereotactic atlas. A single dose of 120 to 140 Gy was delivered to the target point with a single 4-mm isocenter. Patients were followed clinically and with neuroimaging studies. Pain relief was scored as excellent (75-100%), good (50-75%), poor (25-50%); or none (0-25%). Follow up ranged from 6 to 53 months. There were no GKS-related complications. Two patients died of unrelated medical illnesses but had good or excellent pain relief until death. One patient continues to survive with 44 months follow up and no decrease in pain intensity, but with a decreased area of pain. CONCLUSIONS: Combined GKS of the centromedian nucleus and trigeminal nerve in a single treatment session is feasible and safe, and the effect was promising. A larger study is required to confirm and expand these results.


Assuntos
Herpes Zoster/virologia , Radiocirurgia/instrumentação , Radiocirurgia/métodos , Tálamo/cirurgia , Neuralgia do Trigêmeo/cirurgia , Neuralgia do Trigêmeo/virologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Dor/diagnóstico , Manejo da Dor , Doses de Radiação , Tálamo/patologia , Tálamo/virologia , Fatores de Tempo , Neuralgia do Trigêmeo/patologia
17.
Minerva Stomatol ; 53(1-2): 49-59, 2004.
Artigo em Italiano | MEDLINE | ID: mdl-15041920

RESUMO

Herpes zoster (shingles) is caused when the varicella zoster virus that has remained latent since an earlier varicella infection (chicken-pox) is reactivated. Herpes Zoster is a less common and endemic disease than varicella: factors causing reactivation are still not well known, but it occurs in older and/or immunocompromised individuals. Following reactivation, centrifugal migration of herpes zoster virus (HZV) occurs along sensory nerves to produce a characteristic painful cutaneous or mucocutaneous vesicular eruption that is generally limited to the single affected dermatome. Herpes zoster may affect any sensory ganglia and its cutaneous nerve: the most common sites affected are thoracic dermatomes (56%), followed by cranial nerves (13%) and lumbar (13%), cervical (11%) and sacral nerves (4%). Among cranial nerves, the trigeminal and facial nerves are the most affected due to reactivation of HZV latent in gasserian and geniculated ganglia. The 1st division of the trigeminal nerve is commonly affected, whereas the 2nd and the 3rd are rarely involved. During the prodromal stage, the only presenting symptom may be odontalgia, which may prove to be a diagnostic challenge for the dentist, since many diseases can cause orofacial pain, and the diagnosis must be established before final treatment. A literature review of herpes zoster of the trigeminal nerve is presented and the clinical presentation, differential diagnosis and treatment modalities are underlined. A case report is presented.


Assuntos
Herpes Zoster , Neuralgia do Trigêmeo/virologia , Idoso , Idoso de 80 Anos ou mais , Herpes Zoster/diagnóstico , Herpes Zoster/terapia , Humanos , Masculino , Neuralgia do Trigêmeo/diagnóstico , Neuralgia do Trigêmeo/terapia
18.
Indian J Dent Res ; 13(1): 11-4, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12420562

RESUMO

A case of herpes zoster of the trigeminal nerve with complications of osteonecrosis and neuralgia in the absence of local or systemic predisposing factors is presented. The literature is reviewed and the role of varicella zoster virus in the pathology of tooth exfoliation and osteonecrosis is discussed.


Assuntos
Herpes Zoster/diagnóstico , Doenças Mandibulares/virologia , Osteonecrose/virologia , Esfoliação de Dente/virologia , Neuralgia do Trigêmeo/virologia , Idoso , Processo Alveolar/virologia , Dente Pré-Molar/virologia , Dente Canino/virologia , Humanos , Masculino
19.
Med Hypotheses ; 59(5): 603-6, 2002 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-12376087

RESUMO

The etiology and pathogenesis of major trigeminal neuralgia remain largely unknown, but are believed to result from an irritative lesion near the semilunar ganglion. We suggest that its primary cause is a single, active DNA sequence in the persistent but non-integrated genome of latent herpes simplex virus type 1 commonly observed in a few infected A-delta nerve fibers of the cheek. Facial pain occurs as a result of herpes virus reactivation and when supplies of neurotrophins controlling normal transport functions of axolemmal ion channels become depleted.


Assuntos
DNA Viral/genética , Genes Precoces , Genes Virais , Herpes Simples/complicações , Herpesvirus Humano 1/genética , Neuralgia do Trigêmeo/etiologia , Adulto , Antivirais/farmacologia , Antivirais/uso terapêutico , Criança , Regulação Viral da Expressão Gênica , Herpes Simples/genética , Herpesvirus Humano 1/patogenicidade , Humanos , Canais Iônicos , Modelos Neurológicos , Fator de Crescimento Neural/fisiologia , RNA Viral/biossíntese , RNA Viral/genética , Receptores de Fator de Crescimento Neural/fisiologia , Gânglio Trigeminal/virologia , Neuralgia do Trigêmeo/tratamento farmacológico , Neuralgia do Trigêmeo/fisiopatologia , Neuralgia do Trigêmeo/virologia , Latência Viral/genética
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