Trigeminal neuralgia and chiropractic care: a case report.
Summary of "Trigeminal neuralgia and chiropractic care: a case report."
The following case describes a 68 year-old woman with a 7(1/2) year history of worsening head and neck pain diagnosed as trigeminal neuralgia following surgical resection of a brain tumor. After years of unsuccessful management with medication and physical therapies, a therapeutic trial of chiropractic was carried out. Chiropractic care included ultrasound, manual therapies (manipulation and mobilization), soft tissue therapies, and home stretching exercises. After an initial treatment period followed by 18 months of supportive care the patient reported satisfactory improvement. It became evident that there were at least three sources of her symptoms: mechanical and/or degenerative neck pain, temporomandibular joint syndrome, and trigeminal neuralgia. While never completely pain-free, the patient continued to report that her pains reduced to minimal at times. At the most recent follow-up, the pain had not returned to pre-treatment intractable levels. This case study demonstrates the importance of diagnosing and treating multiple sources of pain and the positive role chiropractic care can have in the management of patients with these clinical conditions. The potential for convergence of sensory input from the upper three cervical segments and the trigeminal nerve via the trigeminocervical nucleus is discussed.
Affiliation
Graduate Student, Graduate Education and Research Programs Canadian Memorial Chiropractic College, Toronto, Ontario Private Practice, Smiths Falls, Ontario.
Journal Details
This article was published in the following journal.
Name: The Journal of the Canadian Chiropractic Association
ISSN: 0008-3194
Pages: 177-86
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20808617
- DOI: http://dx.doi.org/
Medical and Biotech [MESH] Definitions
Trigeminal Nerve Diseases
Diseases of the trigeminal nerve or its nuclei, which are located in the pons and medulla. The nerve is composed of three divisions: ophthalmic, maxillary, and mandibular, which provide sensory innervation to structures of the face, sinuses, and portions of the cranial vault. The mandibular nerve also innervates muscles of mastication. Clinical features include loss of facial and intra-oral sensation and weakness of jaw closure. Common conditions affecting the nerve include brain stem ischemia, INFRATENTORIAL NEOPLASMS, and TRIGEMINAL NEURALGIA.
Trigeminal Neuralgia
A syndrome characterized by recurrent episodes of excruciating pain lasting several seconds or longer in the sensory distribution of the trigeminal nerve. Pain may be initiated by stimulation of trigger points on the face, lips, or gums or by movement of facial muscles or chewing. Associated conditions include MULTIPLE SCLEROSIS, vascular anomalies, ANEURYSMS, and neoplasms. (Adams et al., Principles of Neurology, 6th ed, p187)
Trigeminal Nuclei
Nuclei of the trigeminal nerve situated in the brain stem. They include the nucleus of the spinal trigeminal tract (TRIGEMINAL NUCLEUS, SPINAL), the principal sensory nucleus, the mesencephalic nucleus, and the motor nucleus.
Facial Neuralgia
Neuralgic syndromes and other conditions which feature chronic or recurrent FACIAL PAIN as the primary manifestation of disease. Disorders of the trigeminal and facial nerves are frequently associated with these conditions.
Trigeminal Nucleus, Spinal
Nucleus of the spinal tract of the trigeminal nerve. It is divided cytoarchitectonically into three parts: oralis, caudalis (TRIGEMINAL CAUDAL NUCLEUS), and interpolaris.
PubMed Articles
Postherpetic neuralgia has been variably defined but is generally understood to be pain that persists for longer than a few months after an attack of herpes zoster. Pain persists for years in approxim...
Case series: non vascular considerations in trigeminal neuralgia.
An abnormal vascular course of the superior cerebellar artery is often cited as the cause for trigeminal neuralgia. However, among patients with TN-like symptoms, 6% to 16% are variously reported to h...
Chilli for therapy of trigeminus neuralgia : A case report.
We report the case of a 39-year-old female patient who suffered from trigeminal neuralgia of the left lingual nerve for 6 years. The previous therapy according to the guidelines including a Jannetta o...
BACKGROUND: Trigeminal neuralgia (TN) is primarily diagnosed by symptoms and patient history. Magnetic resonance (MR) imaging can be helpful in visualizing the neurovascular compression of the trigemi...
A case of combined glossopharyngeal and trigeminal neuralgia.
It is well-known that idiopathic neuralgias of the trigeminal and glossopharyngeal nerves are caused by vascular compression at the root entry zone of the cranial nerves. Because they are functional d...
Clinical Trials
This research study will look at the safety (e.g., the occurrence of side effects) and efficacy (how well the drug works in reducing trigeminal neuralgia attacks) of a drug called lamotrig...
Clinical Trial of Hyperbaric Oxygen Treatment in Trigeminal Neuralgia Patients
The purpose of this study is to determine whether the hyperbaric oxygen treatment reduces pain and improve the life quality in trigeminal neuralgia patients.
Efficacy and Safety Study of Lamotrigine to Treat Trigeminal Neuralgia
The purpose of this study was to determine the efficacy and safety of lamotrigine in patients with trigeminal neuralgia (TGN).
Randomized Study of L-Baclofen in Patients With Refractory Trigeminal Neuralgia
OBJECTIVES: I. Evaluate the efficacy of L-baclofen in patients with refractory trigeminal neuralgia. II. Evaluate the safety and tolerance of L-baclofen in these patients.
Chiropractic Care, Medication, and Self-Care for Neck Pain
This study will compare the effectiveness of chiropractic care, medications, and self-care on neck pain, a very common condition. The broad, long-term objective of this study is to identif...
