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Related Concept Videos

Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
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Neuromodulation for Trigeminal Neuralgia.

Moonyoung Chung1, Ryoong Huh2

  • 1Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhayng University College of Medicine, Bucheon, Korea.

Journal of Korean Neurosurgical Society
|May 16, 2022
PubMed
Summary

Neuromodulation for trigeminal neuralgia shows limited success due to incomplete understanding of chronic trigeminal neuropathy. Further research into complex pain processing is needed for effective neuromodulation strategies.

Keywords:
Deep brain stimulationFacial painTrigeminal caudal nucleusTrigeminal neuralgia

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Area of Science:

  • Neurology
  • Pain Medicine
  • Neuroscience

Background:

  • Clinical neuromodulation for trigeminal neuralgia (TN) has yielded suboptimal results.
  • The underlying pathophysiology of chronic trigeminal neuropathy remains incompletely understood.
  • Chronic trigeminal neuropathy encompasses trigeminal autonomic neuropathy, painful trigeminal neuropathy, and persistent idiopathic facial pain.

Purpose of the Study:

  • To highlight the need for a comprehensive understanding of the pain processing system in chronic trigeminal neuropathy.
  • To identify potential neuromodulation targets involved in the complex sensory, affective, and emotional components of pain.
  • To underscore the current limitations and future directions for neuromodulation in TN treatment.

Main Methods:

  • Review of current clinical findings in neuromodulation for TN.
  • Analysis of the complex pain processing system.
  • Identification of potential neuromodulation targets within the central and peripheral nervous system.

Main Results:

  • Current neuromodulation interventions for TN have not demonstrated significant efficacy.
  • Chronic trigeminal neuropathy involves intricate abnormalities in sensory, emotional, and affective pain processing.
  • Several potential neuromodulation targets were identified, including the ventral posterior medial nucleus, periaqueductal gray, and anterior cingulate cortex.

Conclusions:

  • Effective neuromodulation for trigeminal neuralgia requires an integrative approach to understanding the pain system.
  • Future advancements in understanding pain processing are crucial for developing successful neuromodulation therapies.
  • Neuromodulation interventions for TN are still under investigation and require further elucidation.