Atlantoaxial fixation as treatment of trigeminal neuralgia in a patient having basilar invagination.

08:00 EDT 20th June 2019 | BioPortfolio

Summary of "Atlantoaxial fixation as treatment of trigeminal neuralgia in a patient having basilar invagination."

We report a case of a 36-year-old male patient who presented with primary symptom of trigeminal neuralgia for a period of 2 years. Investigations revealed presence of basilar invagination and an ectatic vertebral artery loop in the vicinity of the trigeminal nerve. The patient underwent atlantoaxial fixation on the basis of the concept that atlantoaxial instability is the nodal point of pathogenesis of basilar invagination. Atlantoaxial fixation resulted in complete and lasting relief from symptom of trigeminal neuralgia. The pathogenesis of trigeminal neuralgia and its relationship with atlantoaxial instability is speculated.


Journal Details

This article was published in the following journal.

Name: World neurosurgery
ISSN: 1878-8769


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Medical and Biotech [MESH] Definitions

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.

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)

Withholding or withdrawal of a particular treatment or treatments, often (but not necessarily) life-prolonging treatment, from a patient or from a research subject as part of a research protocol. The concept is differentiated from REFUSAL TO TREAT, where the emphasis is on the health professional's or health facility's refusal to treat a patient or group of patients when the patient or the patient's representative requests treatment. Withholding of life-prolonging treatment is usually indexed only with EUTHANASIA, PASSIVE, unless the distinction between withholding and withdrawing treatment, or the issue of withholding palliative rather than curative treatment, is discussed.

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.

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.

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