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Trigeminal Pain

Andrea Tinnirello on June 13, 2018 at 9:42 am

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    • Andrea TinnirelloAndrea Tinnirello
      Joined: Dec 20, 2016
      Posts: 0

      I would like to ask for your opinion for this case.
      A 71 year old woman who underwent surgery for removal of a vast meningioma of the clivus 10 years ago.
      After surgery she developed severe pain in left V1 and V2 trigeminal branches not responding to pharmacological management.
      MRI shows a lesion of trigeminal roots near the root entry zone.
      I don’t believe that Gasser or peripheral RF would work because of the deafferentation of nerve fibers
      There are some reports of HF SCS with the catheter tip up to C1 for managing refractory trigeminal neuralgia, what is your opinion?
      Andrea Tinnirello MD,FIPP

      • Ricardo Ruiz-LopezRicardo Ruiz-Lopez
        Joined: Sep 26, 2017
        Posts: 0

        Trigeminal nucleus is the largest of the Cranial Pairs Nerves. As a neural paleostructure It covers multiple essential functions for living beings, including prevertebral species. Namely, sensorial face innervation and masticatory function.
        Trigeminal Nucleus spreads into the Stem from the Mesemcephalic, Pons, and Bulbar regions down to the superior cervical segments C1- C2.
        Hypothetically this difficult and rare case, could be tributary for a trial of SCS up in the cord for epidural electrical stimulation.

        Ricardo Ruiz-Lopez

        • Passam Fatayerpassam fatayer
          Joined: Jun 3, 2018
          Posts: 0

          If the case didn’t respond to pharmacological management ,try acupuncture,safe procedure.

          -Passam Fatayer

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