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Source publication
Purpose
To determine the prevalence and clinical characteristics of trigeminal–cervical (TC) ocular referred pain.
Methods
A retrospective study of 1,680 patients seen during 2002–2010 was performed in an ocular surface specialty center to identify patients with or without TC pain defined as ocular pain with ipsilateral trigger points located at t...
Citations
... Few systematic reviews evaluate the efficacy of physical therapy interventions, and a limited number of randomized controlled trials (RCTs) evaluate any particular physical therapy intervention. 13,21,22 These reviews suggest that MT combined with other interventions improves outcomes for those with TMJ dysfunction. 5,19,23 However, limitations with those reviews and their supporting evidence makes it difficult to determine the efficacy of cervical spine joint mobilizations or manipulations. ...
Objective
To evaluate the efficacy of upper cervical joint mobilisation and/or manipulation on reducing pain and improving maximal mouth opening (MMO) and pressure pain thresholds (PPTs) in adults with temporomandibular joint (TMJ) dysfunction compared with sham or other intervention.
Data Sources
: MEDLINE, CINAHL, EMBASE and Cochrane Library from inception to June 3, 2022 were searched.
Study Selection
: Eight randomised controlled trials (RCTs) with 437 participants evaluating manual therapy (MT) vs. sham and MT vs. other intervention were included. Two reviewers independently extracted data and assessed risk of bias.
Data Extraction
: Two independent reviewers extracted information about origin, number of study participants, eligibility criteria, type of intervention, and outcome measures.
Data Synthesis
: Manual therapy was statistically significant in reducing pain compared to sham (Mean Difference (MD): -1.93 points, 95% Confidence Interval (CI): -3.61 to -0.24, p= 0.03), and other intervention (MD: -1.03 points, 95% CI: -1.73 to -0.33, p= 0.004), improved MMO compared to sham (MD: 2.11 mm, 95% CI: 0.26 to 3.96, p= 0.03), and other intervention (MD: 2.25 mm, 95% CI: 1.01 to 3.48, p< 0.001), but not statistically significant in improving PPT of masseter compared to sham (MD: 0.45 kg/cm², 95% CI: -0.21 to 1.11, p= 0.18), and other intervention (MD: 0.42 kg/cm², 95% CI: -0.19 to 1.03, p= 0.18), or the PPT of temporalis compared to sham (MD: 0.37 kg/cm², 95% CI: -0.03 to 0.77, p= 0.07), and other intervention (MD: 0.43 kg/cm², 95% CI: -0.60 to 1.45, p= 0.42).
Conclusion
: There appears to be limited benefit of upper cervical spine MT on TMJ dysfunction, but definitive conclusions cannot be made due to heterogeneity and imprecision of treatment effects.
... This is trigemino-cervical referred pain, which even if presented as a single symptom, without headache, is a disease entity independent of the known ophthalmic spectrum of symptoms. It disappears as soon as the interaction of the trigeminal with the cervical limb is interrupted (34). ...
Background: Cervicogenic headache is a chronic cause of pain with a symptomatology varying between neck pain, instability while walking, dizziness, vertigo, ear pain, eye pain, and unilateral tinnitus, which is leading to increased morbidity and use of analgesics. Currently, the contribution of the local infusion of lidocaine in the treatment of cervicogenic headache is very significant. Methods: In this pilot study, eight patients with cervicogenic headache were examined between February 2017 and August 2017 and treated with a three-scale method combining: 1) transcutaneous electric nerve stimulation (TENS); 2) minimally invasive methods of lidocaine injections and nerve blocks; and 3) stretching of the cervical and trapezoidal muscles. Results: The results show that the combined three-step therapy decreases both pain intensity based on VAS score and constant use of analgesics. Conclusion: Three-step therapy can be conducted in one session or multiple sessions and appear to constitute a minimally invasive technique that decreases analgesic use, reducing not only their adverse effects and interactions with other pharmaceutics but also the cost of their use.
... In another cohort study that compared the rates of TN to GN, the occurrence for TN was found to be lower than that of the one in Germany, but still the ratio of occurrence for TN to GN was 5.9:1 [26] reflecting that, of the neuralgias, TN occurs at a greater frequency than GN. Occipital neuralgia's true prevalence is not yet known, and to complicate things further, studies have shown that convergence of cervical afferent fibers can occur with trigeminal nerve fibers leading to ocular as well as occipital pain, suggesting it may be more difficult to ascertain the prevalence [49,51,52]. ...
Introduction
Debilitating facial pain can seriously affect an individual’s daily living. Given that the pathophysiology behind neuropathic and myofascial pain is not fully understood, when chronic facial pain goes undiagnosed, it has been proposed that one of the two is the likely cause. Since their discovery, glossopharyngeal neuralgia (GN) and Eagle’s syndrome have been considered mostly conditions afflicting the adult population. However, when pediatric patients present with symptoms resembling GN or Eagle’s syndrome, physicians are less apt to include these as a differential diagnosis simply due to the low prevalence and incidence in the pediatric population.
Materials and methods
A literature review was performed with the aim to better understand the history of reported cases and to provide a comprehensive report of the anatomical variations that lead to these two conditions as well as the way these variations dictated medical and surgical management. Articles were obtained through Google Scholar and PubMed. Search criteria included key phrases such as pediatric glossopharyngeal neuralgia and pediatric Eagle syndrome. These key phrases were searched independently. PubMed was searched primarily then cross-referenced articles were found via Google Scholar. Results from non-English articles were excluded.
Results
A total of 58 articles were reviewed. Most of the articles focused on adult glossopharyngeal neuralgia, and the majority was comprised of case reports. When searched via PubMed, a total of 16 articles and 2 articles returned for glossopharyngeal neuralgia and Eagle’s syndrome, respectively. After criteria selection and cross-referencing, a total of seven articles were found with respect to pediatric glossopharyngeal neuralgia.
Conclusions
While they are rare conditions, there are multiple etiologies that lead to the debilitating symptoms of GN and Eagle’s syndrome. The clinical anatomy proved notable as multiple causes of GN and Eagle’s syndrome are due to variation in the anatomy of the neurovascular structures surrounding the glossopharyngeal nerve, an elongated styloid process, a calcified stylohyoid ligament as well as a calcified stylomandibular ligament. Due to the success of different treatment modalities, the treatment of choice is dependent on clinical judgment.
Introduction
Acute trigeminal neuralgia exacerbation is a common reason for frequent emergency department visits, that often occurs while waiting for surgery, but evidence on effective drugs for acute trigeminal neuralgia is scant. Whether lidocaine aerosol could be a rescue option for the treatment of acute trigeminal neuralgia exacerbations is worth exploring. Positive predictors of the analgesic effects of lidocaine aerosol also warrant further investigation.
Methods
This is a retrospective study with a total of 152 patients. We analyzed the efficacy of lidocaine aerosol for the treatment of acute trigeminal neuralgia exacerbations. A positive response was considered a decrease in the VAS score of at least 50% at 30 min of treatment. Multivariable logistic analyses were performed to identify predictive factors for lidocaine aerosol response.
Results
In the group of 109 responders, the VAS score decreased from 8.3 ± 1.1 cm to 0.8 ± 1.0 cm at 15 min, and 1.7 ± 1.0 cm at 30 min. The effective rate at 15 min and 30 min were 77.6% and 70.4%, respectively. Multivariate logistic analyses showed the treatment may provide better clinical outcomes in V2 trigeminal neuralgia (OR 0.01, 95%Cl 0.001–0.15, p < 0.001), V3 trigeminal neuralgia (OR 0.02, 95%Cl 0.001–0.16, p = 0.001), and V2 + V3 trigeminal neuralgia (OR 0.01, 95%Cl 0.001–0.13, p < 0.001), patients who were taking carbamazepine or oxcarbazepine with a maximum dose (OR 6.15, 95%Cl 2.11–17.93, p = 0.001) were less likely to experience immediate pain relief.
Conclusion
Lidocaine aerosol sprayed on oral and/or nasal mucosa is beneficial for immediate pain relief in patients with acute trigeminal neuralgia exacerbations. It is expected to become a promising treatment option for patients with V2 and/or V3 trigeminal neuralgia.
