Intraoperative monitoring of sensory part of the trigeminal nerve using blink reflex during microvascular decompression for trigeminal neuralgia. 2018

Valentina Simioni, and J G Capone, and E Sette, and E Granieri, and M Farneti, and M A Cavallo, and V Tugnoli
Department of Neuroscience and Rehabilitation, Division of Neurology, 'S. Anna' University-Hospital, Via Aldo Moro 8, 44121, Cona, Ferrara, Italy. valentina.simioni@gmail.com.

Intraoperative monitoring during cerebellopontine angle surgery is widely accepted. While techniques which monitor cranial motor nerves are commonly used, monitoring the sensory afferents has been challenging. Considering the reflex arc, blink reflex (BR) might be useful in monitoring the sensory part of the trigeminal nerve, the brainstem connections and the facial nerve. We describe the case of a patient who developed hemifacial hypoesthesia after microvascular decompression surgery for trigeminal neuralgia. Intraoperative BR showed a severe loss of R1 amplitude. BR might be a useful intraoperative technique to monitor the sensory part of the trigeminal nerve.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001767 Blinking Brief closing of the eyelids by involuntary normal periodic closing, as a protective measure, or by voluntary action. Orbicularis Oculi Reflex,Reflex, Blink,Reflex, Corneal,Reflex, Orbicularis Oculi,Winking,Blink Reflexes,Corneal Reflexes,Orbicularis Oculi Reflexes,Blink Reflex,Reflexes, Blink,Reflexes, Orbicularis Oculi
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014276 Trigeminal Nerve The 5th and largest cranial nerve. The trigeminal nerve is a mixed motor and sensory nerve. The larger sensory part forms the ophthalmic, mandibular, and maxillary nerves which carry afferents sensitive to external or internal stimuli from the skin, muscles, and joints of the face and mouth and from the teeth. Most of these fibers originate from cells of the TRIGEMINAL GANGLION and project to the TRIGEMINAL NUCLEUS of the brain stem. The smaller motor part arises from the brain stem trigeminal motor nucleus and innervates the muscles of mastication. Cranial Nerve V,Fifth Cranial Nerve,Nerve V,Nervus Trigeminus,Cranial Nerve, Fifth,Fifth Cranial Nerves,Nerve V, Cranial,Nerve Vs,Nerve, Fifth Cranial,Nerve, Trigeminal,Trigeminal Nerves,Trigeminus, Nervus
D014277 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) Tic Doloureux,Tic Douloureux,Epileptiform Neuralgia,Fothergill Disease,Secondary Trigeminal Neuralgia,Trifacial Neuralgia,Trigeminal Neuralgia, Idiopathic,Trigeminal Neuralgia, Secondary,Disease, Fothergill,Epileptiform Neuralgias,Idiopathic Trigeminal Neuralgia,Idiopathic Trigeminal Neuralgias,Neuralgia, Epileptiform,Neuralgia, Idiopathic Trigeminal,Neuralgia, Secondary Trigeminal,Neuralgia, Trifacial,Neuralgia, Trigeminal,Secondary Trigeminal Neuralgias,Trifacial Neuralgias,Trigeminal Neuralgias
D016343 Monitoring, Intraoperative The constant checking on the state or condition of a patient during the course of a surgical operation (e.g., checking of vital signs). Intraoperative Monitoring
D061145 Microvascular Decompression Surgery Surgery performed to relieve pressure from MICROVESSELS that are located around nerves and are causing NERVE COMPRESSION SYNDROMES. Microvascular Decompression,Decompression Surgeries, Microvascular,Decompression Surgery, Microvascular,Decompression, Microvascular,Decompressions, Microvascular,Microvascular Decompression Surgeries,Microvascular Decompressions,Surgeries, Microvascular Decompression,Surgery, Microvascular Decompression

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