Return to "Giving Something Back"


Medical Literature on Trigeminal Neuropathy 

Database Search on PubMed:  week of June 9, 2003

filtering by  Richard A. Lawhern, Ph.D.

 

For more resources on face pain, see my homepage: "Giving Something Back"

 

Companion Collection:  "Medical Literature on Trigeminal Neuralgia"

 

First, a word of explanation:  This article provides a collection of filtered abstracts on trigeminal neuropathy, from the National Library of Medicine, obtained by searching PubMed at National Institutes of Health.  For readers who may not be familiar with PubMed, it is a major resource for physicians, researchers, and the public at large.  If you are a chronic pain patient or trying to support someone who is, then you may -- and should -- learn your way around in this resource by selecting the following link and running some inquiries of your own:   

 

Gateway to Pub Med... 

 

Each citation is organized as follows:

 

- Authors, if known

- "Abstract " [if the article has one] or "No Abstract - " if the only thing carried at Pub Med is a notation that the article exists.

- Journal Title, volume and date

-PMID - Pub Med ID number - a unique tracking number assigned to each citation in the Pub Med database (of over 9 million).  

 

For articles that seem to offer information of direct interest to face pain patients, I have downloaded and included the Abstract  with its citation description.  Titles of such abstracts are in bold print.  As you read, please be mentally prepared to see more than a few differences of opinion even between the so-called "experts," concerning the efficacy of treatments and even the origins of facial pain and neuropathy.  This is perhaps even more true for facial neuropathy than for trigeminal neuralgia, a related disorder with many symptoms that overlap.   

 

When publishers send abstracts to PubMed for indexing, they are increasingly providing hot links to on-line full-text sources for the original articles.  So far, very little of this material is "free", though at least a few selected items are available.  If you're willing to pay a fee for obtaining the full text, then you may want to enter the Pub Med gateway and search for a PMID number as your target.   

 

If you're living near a major University that has a medical school, you may be able to find the journal in the library and make a copy.  For lesser known journals and if you don't have a University nearby, you can take the citation to a good county library and ask whether they can obtain the item on interlibrary loan.  

 

Feel free to inquire by email if you need assistance translating this material.  Many doctors write for the consumption of other doctors, not the general public.  Email link: Richard A. Lawhern, Ph.D.   

 

The citations which follow appeared at the top of a stack of almost 3600 "hits" on the terms "Trigeminal" and "Neuropathy." These are dated between approximately March 2002 and June 2003.  In the original Pub Med search results, titles are displayed in response to the search, and the Abstracts are hot-linked from the titles.  However, I have waded through the lot, to detect citations which seem most directly of interest and use.  My reading is not perfect.  But I've been doing this as an informed layman for about seven years, so I'll hope by this time to have reasonably good instincts. 

 

For the term "trigeminal neuropathy," we observe a lot more "splatter" and imprecise references than we do for "trigeminal neuralgia."  Both can be difficult to diagnose.  But neuropathy is still in some ways a label rather than a diagnosis.  Thus you will see fewer abstracts in this compilation that seem directly pertinent.  You will also see abstracts that address typical or atypical trigeminal neuralgia.  There is overlap in both the symptoms and treatments of these disorders, so you will need to learn something about both.  This is one of many places to start.  Others are referenced in a collection of bookmarks found on my main page:  "Giving Something Back"

 


Citations and Abstracts from PubMed:  Trigeminal Neuropathy

1: Plas J. 
Abstract -  [Cranial nerve vascular compression syndromes and neurogenic hypertension]
Rozhl Chir. 2003 Mar;82(3):123-8. Review. Czech.
PMID: 12728559 [PubMed - indexed for MEDLINE]

Microvascular Decompression Surgery in the United States, 1996 to 2000: Mortality Rates, Morbidity Rates, and the Effects of Hospital and Surgeon Volumes.

Kalkanis SN, Eskandar EN, Carter BS, Barker FG 2nd, FG.

Neurosurgical Service, Massachusetts General Hospital, and Department of Surgery, Harvard Medical School, Boston, Massachusetts.

OBJECTIVE: Microvascular decompression (MVD) is associated with low mortality and morbidity rates at specialized centers, but many MVD procedures are performed outside such centers. We studied short-term end points after MVD in a national hospital discharge database sample. METHODS: A retrospective cohort study was performed by using the Nationwide Inpatient Sample, 1996 to 2000. RESULTS: The sample included 1326 MVD procedures for treatment of trigeminal neuralgia, 237 for treatment of hemifacial spasm, and 27 for treatment of glossopharyngeal neuralgia, performed at 305 hospitals by 277 identified surgeons. The mortality rate was 0.3%, and the rate of discharge other than to home was 3.8%. Neurological complications were coded in 1.7% of cases, hematomas in 0.5%, and facial palsies in 0.6%, with 0.4% of patients requiring ventriculostomies and 0.7% postoperative ventilation. Trigeminal nerve section was also coded for 3.4% of patients with trigeminal neuralgia, more commonly among older patients (P = 0.08), among female patients (P = 0.03), and at teaching hospitals (P = 0.02). The median annual caseloads were 5 cases per hospital (range, 1-195 cases) and 3 cases per surgeon (range, 1-107 cases). With adjustment for age, sex, race, primary insurance, diagnosis (trigeminal neuralgia versus hemifacial spasm versus glossopharyngeal neuralgia), geographic region, admission type and source, and medical comorbidities, outcomes at discharge were superior at higher-volume hospitals (P = 0.006) and with higher-volume surgeons (P = 0.02). Complications were less frequent after surgery performed at high-volume hospitals (P = 0.04) or by high-volume surgeons (P = 0.01). The rate of discharge other than to home was 5.1% for the lowest-volume-quartile hospitals, compared with 1.6% for the highest-volume-quartile hospitals. Volume and mortality rate were not significantly related, but three of the four deaths in the series followed procedures performed by surgeons who had performed only one MVD procedure that year. Length of stay (median, 3 d) and hospital volume were not significantly related. Hospital charges were slightly higher at higher-volume hospitals (P = 0.007). CONCLUSION: Although most MVD procedures in the United States are performed at low-volume centers, mortality rates remain low. Morbidity rates are significantly lower at high-volume hospitals and with high-volume surgeons.


2: Fehr J. 
No abstract - [A different headache]
Schweiz Rundsch Med Prax. 2003 Mar 19;92(12):558-61. German. No abstract - available.
PMID: 12693148 [PubMed - indexed for MEDLINE]


3: Maher CO, Atkinson JL, Lane JI. 
Abstract -  Arteriovenous malformation in the trigeminal nerve. Case report.
J Neurosurg. 2003 Apr;98(4):908-12.
PMID: 12691421 [PubMed - indexed for MEDLINE]


4: Huang E, Teh BS, Zeck O, Woo SY, Lu HH, Chiu JK, Butler EB, Gormley WB, Carpenter LS. 
Abstract -  Gamma knife radiosurgery for treatment of trigeminal neuralgia in multiple sclerosis patients.
Stereotact Funct Neurosurg. 2002;79(1):44-50.
PMID: 12677104 [PubMed - indexed for MEDLINE]

Gamma knife radiosurgery for treatment of trigeminal neuralgia in multiple sclerosis patients.

Huang E, Teh BS, Zeck O, Woo SY, Lu HH, Chiu JK, Butler EB, Gormley WB, Carpenter LS.

Baylor College of Medicine, Houston, Tex 77030, USA.

BACKGROUND: Trigeminal neuralgia is a paroxysmal pain syndrome commonly associated with multiple sclerosis. While gamma knife radiosurgery has been shown to be an effective treatment for most cases of trigeminal neuralgia, it is considered to be less efficacious in patients with multiple sclerosis and less viable as a treatment option. METHODS: Seven patients with multiple-sclerosis-associated trigeminal neuralgia were identified from 50 consecutive patients treated for trigeminal neuralgia at the Memorial-Hermann Gamma Knife Radiosurgery Center. A Leksell gamma knife was used to deliver 80 or 90 Gy to a single 4-mm isocenter targeting the fifth nerve root entry zone into the pons. The patients were followed for a median period of 28 months and graded on a scale of 1 to 5, adopted from the Barrow Neurological Institute. RESULTS: All 7 patients showed excellent responses to radiosurgery with complete resolution of their pain and cessation of pain medications. The time to maximal response varied from 1 day to 8 months after treatment. The only complication was persistent facial numbness over the distribution of V2 and V3 which occurred in 4 patients. One patient experienced a recurrence of pain (grade 3) 24 months after radiation treatment, and she is currently being treated with carbamazepine. CONCLUSIONS: Gamma knife radiosurgery is an effective treatment option for trigeminal neuralgia patients with multiple sclerosis. These patients should be informed that there appears to be a higher incidence of facial numbness and that a longer period of several months should be allowed before the full effects of treatment may be observed as compared to the general population. Copyright 2002 S. Karger AG, Basel


5: Cheshire WP. 
No abstract - Trigeminal neuralgia feigns the terrorist.
Cephalalgia. 2003 Apr;23(3):230. No abstract available.
PMID: 12662192 [PubMed - indexed for MEDLINE]


6: Tang BH. 
No abstract - Trigeminal neuralgia.
J Neurosurg. 2003 Mar;98(3):647; author reply 647-8. No abstract available.
PMID: 12650444 [PubMed - indexed for MEDLINE]


7: Fukuda H, Ishikawa M, Okumura R. 
Abstract -  Demonstration of neurovascular compression in trigeminal neuralgia and hemifacial spasm with magnetic resonance imaging: comparison with surgical findings in 60 consecutive cases.
Surg Neurol. 2003 Feb;59(2):93-9; discussion 99-100.
PMID: 12648904 [PubMed - indexed for MEDLINE]

Demonstration of neurovascular compression in trigeminal neuralgia and hemifacial spasm with magnetic resonance imaging: comparison with surgical findings in 60 consecutive cases.

Fukuda H, Ishikawa M, Okumura R.

Department of Neurological Surgery and Radiology, Kitano Hospital, Osaka, Japan

BACKGROUND: Until recently, it has been impossible to demonstrate vascular compression at the root entry or exit zone (REZ) of the trigeminal nerve and facial nerve in patients with trigeminal neuralgia (TN) and hemifacial spasm (HFS) preoperatively, although surgical findings have revealed apparent neurovascular compression and its correction has resulted in a good outcome in most cases. Revealing the anatomic correlation between nerves and vessels at the REZ preoperatively would be useful to predict operative findings. METHODS: To assess whether the vascular contact of the nerve at the REZ could be demonstrated preoperatively, high-resolution magnetic resonance tomographic angiography (MRTA) was performed in 21 patients with TN and 39 with HFS. Neuroradiological findings were compared with the operative findings in all patients. Contralateral asymptomatic nerves were evaluated as a control. RESULTS: MRTA correctly identified offending vessels in 14 (67%) of the 21 TN and 34 (87%) of the 39 HFS patients. Failure to identify neurovascular contact was noted in the cases with compression by veins or small arteries, thickened arachnoid, or distal compression. Neurovascular contact was also observed in 15% of the asymptomatic nerves. The deformity of the nerve seemed to be a more important factor for determining operative indication. CONCLUSIONS: MRTA could demonstrate offending vessels in TN and HFS at a high rate and was useful to predict operative findings. MRTA gave supportive evidence of surgical indications in patients with TN and HFS, although attention should be paid to the fact that MRTA did not necessarily detect all of the offending vessels.

8: Chakraborty A, Bavetta S, Leach J, Kitchen N. 
Abstract -  Trigeminal neuralgia presenting as Chiari I malformation.
Minim Invasive Neurosurg. 2003 Feb;46(1):47-9.
PMID: 12640584 [PubMed - indexed for MEDLINE]


9: Turner CL, Mendoza N, Illingworth RD, Kirkpatrick PJ. 
Abstract -  Measurement of pulse pressure profiles in patients with trigeminal neuralgia.
J Neurol Neurosurg Psychiatry. 2003 Apr;74(4):533-5.
PMID: 12640085 [PubMed - indexed for MEDLINE]


10: Rainov NG, Heidecke V. 
Abstract -  Motor cortex stimulation for neuropathic facial pain.
Neurol Res. 2003 Mar;25(2):157-61. Review.
PMID: 12635515 [PubMed - indexed for MEDLINE]

Motor cortex stimulation for neuropathic facial pain.

Rainov NG, Heidecke V.

University of Liverpool, Department of Neurological Science, Walton Centre for Neurology and Neurosurgery NHS Trust, Clinical Sciences Centre for Research and Education, Lower Lane, Liverpool L9 7LJ, UK. rainov@liv.ac.uk

Facial neuralgia is the last common pathway for a variety of pathological conditions with different etiology. Neuropathic facial pain is often refractory to routine medical or surgical treatments. We present here a long-term follow-up of two patients with unilateral facial neuropathic pain due to idiopathic trigeminal neuropathy or to surgical trauma to the glossopharyngeal nerve, respectively. These patients have been treated by other modalities for several years without obtaining satisfactory pain relief. Electrical stimulation of the motor cortex (MCS) with a quadripolar electrode contralateral to the painful area of the face was attempted in both cases for control of the facial pain, and resulted in immediate analgesia with more than 50% pain reduction. During a follow-up period of 72 months, a sufficient (> 50%) and stable analgesic effect of MCS was observed. These cases are discussed and the recent literature on MCS is reviewed in an attempt to identify indications for MCS as well as key structures in the brain for mediating the MCS effect.

Publication Types:

* Review
* Review of Reported Cases


11: Lee ST, Chen JF. 
Abstract -  Percutaneous trigeminal ganglion balloon compression for treatment of trigeminal neuralgia--part I: pressure recordings.
Surg Neurol. 2003 Jan;59(1):63-6; discussion 66-7.
PMID: 12633968 [PubMed - indexed for MEDLINE]


12: Lord SM, Bogduk N. 
Abstract -  Radiofrequency procedures in chronic pain.
Best Pract Res Clin Anaesthesiol. 2002 Dec;16(4):597-617. Review.
PMID: 12516894 [PubMed - indexed for MEDLINE]

Radiofrequency procedures in chronic pain.

Lord SM, Bogduk N.

Division of Anaesthesia, Intensive Care & Pain Management, John Hunter Hospital, Locked Bag 1, Hunter Region Mail Centre, New South Wales 2310, Australia.

Radiofrequency current is simply a tool used for creating discrete thermal lesions in neural pathways in order to interrupt transmission. In pain medicine, radiofrequency lesions have been used to interrupt nociceptive pathways at various sites. This is a palliative treatment not without complications, so its use should be limited to those patients with cancer pain or chronic non-cancer pain for whom conservative non-surgical therapies have been ineffective or intolerable. With the development of alternatives such as intrathecal opioid infusion and neuromodulation technologies, the number of patients considered for neuroablative therapy may dwindle. Nevertheless, there is evidence that radiofrequency neurotomy has an important role in the management of trigeminal neuralgia, nerve root avulsion and spinal pain. In this chapter the evidence for efficacy and safety is reviewed and interrogated with special emphasis on the available randomized controlled trails and systematic review.

Publication Types:

* Review
* Review, Tutorial



13: Naseri A, Good WV, Cunningham ET Jr. 
Abstract -  Herpes zoster virus sclerokeratitis and anterior uveitis in a child following varicella vaccination.
Am J Ophthalmol. 2003 Mar;135(3):415-7.
PMID: 12614776 [PubMed - indexed for MEDLINE]


14: Thayer T. 
No abstract - Acupuncture: the best of the rest.
SAAD Dig. 2002 Jul;19(3):5-8. No abstract available.
PMID: 12613346 [PubMed - indexed for MEDLINE]


15: Robinson CM, Addy L, Wylie M, Luker J, Eveson JW, Prime SS. 
Abstract -  A study of the clinical characteristics of benign trigeminal sensory neuropathy.
J Oral Maxillofac Surg. 2003 Mar;61(3):325-32.
PMID: 12618972 [PubMed - indexed for MEDLINE]

A study of the clinical characteristics of benign trigeminal sensory neuropathy.

Robinson CM, Addy L, Wylie M, Luker J, Eveson JW, Prime SS.

Division of Oral Medicine, Pathology and Microbiology, Department of Oral and Dental Science, University of Bristol, Bristol, United Kingdom.

PURPOSE: The purpose of this study was to describe the clinical characteristics of a series of patients presenting with benign trigeminal sensory neuropathy. PATIENTS AND METHODS: We conducted a retrospective analysis of the clinical and pathologic characteristics of 23 patients presenting with facial numbness of unknown etiology. RESULTS: Patients presented with diverse medical histories but could be grouped into those with a connective tissue disorder, neurologic disease, psychologic problems, or a medical history of unknown significance. The age of the patient, the severity and distribution of the trigeminal neuropathy, and symptoms other than neuropathy closely reflected the patient's medical history. The majority of patients underwent magnetic resonance imaging, but the results did not facilitate the diagnosis of the condition or reflect the extent and severity of the symptoms. In 60% of patients, the symptoms remained unchanged during the course of the study and outcome was not influenced by medical treatment. CONCLUSIONS: The diagnosis and management of benign trigeminal sensory neuropathy remain a significant clinical challenge. Copyright 2003 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 61:325-332, 2003


16: Matthews R, Philip J. 
No abstract - Cutaneous reaction to carbamazepine.
Br Dent J. 2003 Feb 8;194(3):121. No abstract available.
PMID: 12598877 [PubMed - indexed for MEDLINE]


17: Quinones-Hinojosa A, Chang EF, Khan SA, McDermott MW. 
Abstract -  Isolated trigeminal nerve sarcoid granuloma mimicking trigeminal schwannoma: case report.
Neurosurgery. 2003 Mar;52(3):700-5 discussion 704-5. Review.
PMID: 12590697 [PubMed - indexed for MEDLINE]


18: Wentzky P, Berndt S. 
Abstract -  [Neuralgia of the trigeminal nerve as first symptom of a primary central nervous system lymphoma of non-Hodgkin's type]
Fortschr Neurol Psychiatr. 2003 Feb;71(2):67-71. German.
PMID: 12579469 [PubMed - indexed for MEDLINE]


19: Javadpour M, Eldridge PR, Varma TR, Miles JB, Nurmikko TJ. 
No abstract - Microvascular decompression for trigeminal neuralgia in patients over 70 years of age.
Neurology. 2003 Feb 11;60(3):520. No abstract available.
PMID: 12578946 [PubMed - indexed for MEDLINE]


20: Machado AG, Aguiar PH, Marino R Jr. 
Abstract -  Pathological laughter in a patient with trigeminal neurinoma.
Arq Neuropsiquiatr. 2002 Dec;60(4):1000-2.
PMID: 12563395 [PubMed - indexed for MEDLINE]

21: Chang FL, Huang GS, Cherng CH, Ho ST, Wong CS. 
No abstract - Repeated peripheral nerve blocks by the co-administration of ketamine, morphine, and bupivacaine attenuate trigeminal neuralgia.
Can J Anaesth. 2003 Feb;50(2):201-2. No abstract available.
PMID: 12560318 [PubMed - indexed for MEDLINE]


22: Mursch K, Schafer M, Steinhoff BJ, Behnke-Mursch J. 
Abstract -  Trigeminal evoked potentials and sensory deficits in atypical facial pain--a comparison with results in trigeminal neuralgia.
Funct Neurol. 2002 Jul-Sep;17(3):133-6.
PMID: 12549718 [PubMed - indexed for MEDLINE]

Trigeminal evoked potentials and sensory deficits in atypical facial pain--a comparison with results in trigeminal neuralgia.

Mursch K, Schafer M, Steinhoff BJ, Behnke-Mursch J.

Department of Neurosurgery, Georg-August-Universitat, Gottingen, Germany. kaymu@yahoo.de

Trigeminal evoked potentials (TEPs) and sensory deficits in eighty-three patients admitted for first surgical treatment of facial pain were retrospectively analysed. Thirty-seven patients suffered from trigeminal neuralgia (TN), 10 from symptomatic TN (sTN), and 36 from atypical facial pain (AFP). Eighteen percent of the TN patients reported sensory deficits on the pain side, but 35% had delayed ipsilateral N13 waves. Of the sTN patients, 60% had either sensory deficits or a pathological corneal reflex and 62.5% a pathological N13. Of the AFP patients, 61% complained of sensory deficits, but only 31% had a pathological N13. The percentage of pathological P19 waves was slightly lower (20%, 50%, and 11%, respectively), but showed a similar trend. Normal TEPs were found even in the presence of a sensory deficit (reported only in the AFP group). These findings may add weight to the hypothesis of underlying psychiatric disorders in AFP.


23: Taki W, Matsushima S, Hori K, Mouri G, Ishida F. 
Abstract -  Repositioning of the vertebral artery with titanium bone fixation plate for trigeminal neuralgia.
Acta Neurochir (Wien). 2003 Jan;145(1):55-61.
PMID: 12545263 [PubMed - indexed for MEDLINE]


24: Chen Z, Zhao Z, Li M, Yang Y. 
Abstract -  [Clinical significance of trigeminal neuralgia treated using radiofrequency thermocoagulation (RFT) with different approaches]
Hua Xi Kou Qiang Yi Xue Za Zhi. 2001 Aug;19(4):240-2. Chinese.
PMID: 12539731 [PubMed - indexed for MEDLINE]

[Clinical significance of trigeminal neuralgia treated using radiofrequency thermocoagulation (RFT) with different approaches]

[Article in Chinese]

Chen Z, Zhao Z, Li M, Yang Y.

Department of Stomatology, Chengdu Army General Hospital.

OBJECTIVE: The authors presented the short term and long term effects of the trigeminal neuralgia treated by RFT with anterior-lateral facial, lateral facial and trans-subzygomatic approaches. METHODS: 320 primary patients with trigeminal neuralgia were selected for this study. All these patients were followed up with the period of 1 to 6 years. RESULTS: The first-time effective ratios of pain-relieve treated by using the anterior-lateral facial approach, and the lateral facial and the trans-subzygomatic, were 93.3% and 73.3% respectively. Most of the patients (92.5%) achieved excellent or good pain-relieve after treated by one of these three approaches. Compared with the lateral facial and trans-subzygomatic procedures, the anterior-lateral facial approach caused less recurrent rate in long term effects (P < 0.01). The late recurrence was found in 93 patients, but pain-relieve effect still could be obtained by retreating with the former method and without difficulty or hazard. One patient had serious Rollets syndrome. CONCLUSION: It is concluded that the anterior-lateral approach is a method with more effective pain-relieve and less pain recurrence rate, and the trans-subzygomatic method can be used as a substitutive approach in the treatment of the second branch of trigeminal neuralgia.
25: Liu JB, Wu HJ, Zhu ZF. 
Abstract -  [Evaluation of clinical therapeutic efficacy by injecting adriamycin to the nerve in primary trigeminal neuralgia]
Hunan Yi Ke Da Xue Xue Bao. 2001 Apr 28;26(2):163-4. Chinese.
PMID: 12536657 [PubMed - indexed for MEDLINE]


26: Frese A, Evers S, May A. 
No abstract Autonomic activation in experimental trigeminal pain.
Cephalalgia. 2003 Feb;23(1):67-8. No abstract available.
PMID: 12534584 [PubMed - indexed for MEDLINE]


27: Kaup AO, Mathew NT, Levyman C, Kailasam J, Meadors LA, Villarreal SS. 
Abstract -  'Side locked' migraine and trigeminal autonomic cephalgias: evidence for clinical overlap.
Cephalalgia. 2003 Feb;23(1):43-9. Review.
PMID: 12534580 [PubMed - indexed for MEDLINE]


28: Boes CJ, Matharu MS, Goadsby PJ. 
Abstract -  The paroxysmal hemicrania-tic syndrome.
Cephalalgia. 2003 Feb;23(1):24-8.
PMID: 12534576 [PubMed - indexed for MEDLINE]

The paroxysmal hemicrania-tic syndrome.

Boes CJ, Matharu MS, Goadsby PJ.

Headache Group, Institute of Neurology, London UK.

Two cases of paroxysmal hemicrania (PH) associated with trigeminal neuralgia are reviewed. The paroxysmal hemicrania component in one patient was episodic, while it was chronic in the other. Each headache type responded completely to separate treatment, highlighting the importance of recognizing this association. We review the six other cases of chronic paroxysmal hemicrania-tic (CPH-tic) reported, and suggest that the term paroxysmal hemicrania-tic syndrome (PH-tic) be used to describe this association.


29: Bonicalzi V, Canavero S. 
Abstract -  A case of trigeminal-vagal neuralgia relieved by peripheral self-stimulation.
Acta Neurol Belg. 2002 Dec;102(4):188-90.
PMID: 12534247 [PubMed - indexed for MEDLINE]


30: Arsava EM, Uluc K, Nurlu G, Kansu T. 
No abstract - Electrophysiological evidence of trigeminal neuropathy in pseudotumor cerebri.
J Neurol. 2002 Nov;249(11):1601-2. No abstract available.
PMID: 12532926 [PubMed - indexed for MEDLINE]


31: Bogucki J, Czernicki Z. 
Abstract -  [The effectiveness of microvascular decompression in various types of vascular compression in patients with trigeminal neuralgia]
Neurol Neurochir Pol. 2002 Sep-Oct;36(5):937-46. Polish.
PMID: 12523118 [PubMed - indexed for MEDLINE]

[The effectiveness of microvascular decompression in various types of vascular compression in patients with trigeminal neuralgia]

[Article in Polish]

Bogucki J, Czernicki Z.

Kliniki Neurochirurgii ICMDiK PAN w Warszawie.

The aim of the work was to evaluate the efficacy of microvascular decompression (MVD) in different types of vascular compression (VC) in 20 patients with the idiopathic form of trigeminal neuralgia (TN). The typical VC was found in 17 cases. An arterial vessel was the cause of VC in 6 cases, a venous vessel in 5. The mixed type of VC was present in 6 cases. In every case of the mixed VC one of the vessels compressing the 5th nerve predominated: arterial in 5 and venous in 1. In 3 cases of TN no VC was found. Observation time after MVD was from 6 to 61 months (median 26.7 months). In the TN patients with the arterial VC (including the mixed VC with the arterial predominance) pain relief was complete in 7 cases, satisfactory in 2 and none in 1 case. In patients with venous VC (including mixed VC with venous predominance) pain relief was complete in 4 cases and satisfactory in 2. In the TN patients without VC pain relief was satisfactory in 1, unsatisfactory in 1 and none in 1 case. Long term results of MVD in the analyzed series of the TN patients confirm the efficacy of MVD when vascular compression of the 5th nerve--either arterial or venous--is found intraoperatively.


32: Born JD. 
Abstract -  [Trigeminal neuralgia and hemifacial spasm. Vessel-nerve antagonism]
Bull Mem Acad R Med Belg. 2002;157(3-4):178-86; discussion 186-8. French.
PMID: 12508714 [PubMed - indexed for MEDLINE]


33: Vaughan P, Hampshire A, Soanes T, Kemeny A, Radatz M, Rowe J, Walton L. 
Abstract -  The clinical application of plugging patterns for the Leksell gamma knife.
J Neurosurg. 2002 Dec;97(5 Suppl):579-81.
PMID: 12507100 [PubMed - indexed for MEDLINE]


34: Shetter AG, Rogers CL, Ponce F, Fiedler JA, Smith K, Speiser BL. 
Abstract -  Gamma knife radiosurgery for recurrent trigeminal neuralgia.
J Neurosurg. 2002 Dec;97(5 Suppl):536-8.
PMID: 12507092 [PubMed - indexed for MEDLINE]

Gamma knife radiosurgery for recurrent trigeminal neuralgia.

Shetter AG, Rogers CL, Ponce F, Fiedler JA, Smith K, Speiser BL.

Department of Radiation Oncology, Foundation for Cancer Research and Education, Arizona Oncology Services, Phoenix, Arizona 85013, USA. andrew.shetter@bnaneuro.net

OBJECT: Pain may fail to respond or may recur after initial gamma knife radiosurgery (GKS) for trigeminal neuralgia (TN). The authors examined their experience with performing a second GKS procedure in these patients. METHODS: Twenty-nine patients underwent repeated GKS for TN at our institution between March 1997 and March 2002. Questionnaires were mailed to patients to assess the degree of their pain relief and the extent of facial numbness. Nineteen patients responded. All patients underwent repeated GKS involving a single 4-mm isocenter directed at the trigeminal nerve as it exited the brainstem (mean maximum dose 23.2 Gy). At a mean follow up of 13.5 months after the second procedure, 10 patients (53%) were pain free and medication free. Four patients (21%) were pain free but elected to continue medication in reduced dose, and two patients (11%) had incomplete but satisfactory pain control and were still taking medication. There was new-onset facial numbness in eight patients (42%), rated as tolerable in all instances. CONCLUSIONS: Patients with facial numbness had a greater likelihood of being pain free than those with no sensory loss. The authors observed no cases of corneal anesthesia, keratitis, or deafferentation pain.


35: Chang JW, Choi JY, Yoon Y, Park YG, Chung SS. 
Abstract -  Unusual causes of trigeminal neuralgia treated by gamma knife radiosurgery. Report of two cases.
J Neurosurg. 2002 Dec;97(5 Suppl):533-5.
PMID: 12507091 [PubMed - indexed for MEDLINE]


36: Rogers CL, Shetter AG, Ponce FA, Fiedler JA, Smith KA, Speiser BL. 
Abstract -  Gamma knife radiosurgery for trigeminal neuralgia associated with multiple sclerosis.
J Neurosurg. 2002 Dec;97(5 Suppl):529-32.
PMID: 12507090 [PubMed - indexed for MEDLINE]

Gamma knife radiosurgery for trigeminal neuralgia associated with multiple sclerosis.

Rogers CL, Shetter AG, Ponce FA, Fiedler JA, Smith KA, Speiser BL.

St. Joseph's Hospital and Barrow Neurological Institute, Department of Radiation Oncology Foundation for Cancer Research and Education, Arizona Oncology Services, Phoenix, Arizona 85013, USA. lelandroge@aol.com

OBJECT: The authors assessed the efficacy and complications from gamma knife radiosurgery (GKS) for multiple sclerosis (MS)-associated trigeminal neuralgia (TN). METHODS: There were 15 patients with MS-associated TN (MS-TN). Treatment involved three sequential protocols, 70 to 90-Gy maximum dose, using a single 4-mm isocenter targeting the ipsilateral trigeminal nerve at its junction with the pons with the 50% isodose. Pain was appraised by each patient by using Barrow Neurological Institute (BNI) Scores I through IV: I, no pain; II, occasional pain not requiring medication; IIIa, no pain but continued medication; IIIb, some pain, controlled with medication; IV, some pain, not controlled with medication; and V, severe pain/no pain relief. With a mean follow up of 17 months (range 6-38 months), 12 (80%) of 15 patients experienced pain relief. Three patients (20%) reported no relief (BNI Score V). For responders, the mean latency from treatment to the onset of pain relief was 13 days (range 1-61 days). Maximal relief was achieved after a mean latency of 56 days (range 1-157 days). Five patients underwent a second GKS after a mean interval of 534 days (range 231-946 days). The mean maximum dose at this second treatment was 48 Gy. The target was unchanged from the first treatment. All five patients who underwent repeated GKS improved. Complications were limited to delayed facial hypesthesias. Two (13%) of 15 patients experienced onset of numbness after the first GKS, as well as two of five patients following a second GKS. The patients found this mild and not bothersome. Each patient who developed hypesthesias also experienced complete pain relief. CONCLUSIONS: Gamma knife radiosurgery is an effective treatment for MS-TN. Radiosurgery carries an acceptable small risk of mild facial hypesthesias, and hypesthesia appears predictive of a favorable outcome.

Publication Types:

* Clinical Trial


37: Matsuda S, Serizawa T, Sato M, Ono J. 
Abstract -  Gamma knife radiosurgery for trigeminal neuralgia: the dry-eye complication.
J Neurosurg. 2002 Dec;97(5 Suppl):525-8.
PMID: 12507089 [PubMed - indexed for MEDLINE]


38: Viktorov VA, Domanskii VL. 
Abstract -  [Equipment for electrostimulation of the nervous and muscular systems: investigations, design, and application]
Med Tekh. 2002 Nov-Dec;(6):4-6. Russian.
PMID: 12506735 [PubMed - indexed for MEDLINE]


39: Kondziolka D, Flickinger JC, Lunsford LD. 
No abstract - Energy sources in the posterior fossa: the role of radiosurgery.
Clin Neurosurg. 2002;49:548-61. Review. No abstract available.
PMID: 12506569 [PubMed - indexed for MEDLINE]


40: Rowe JG, Radatz MW, Walton L, Kemeny AA. 
Abstract -  Changing utilization of stereotactic radiosurgery in the UK: the Sheffield experience.
Br J Neurosurg. 2002 Oct;16(5):477-82.
PMID: 12498492 [PubMed - indexed for MEDLINE]

41: Eriksson M, Ben-Menachem E, Andersen O. Related Articles, 
Abstract -  Epileptic seizures, cranial neuralgias and paroxysmal symptoms in remitting and progressive multiple sclerosis.
Mult Scler. 2002 Dec;8(6):495-9.
PMID: 12474990 [PubMed - indexed for MEDLINE]

Epileptic seizures, cranial neuralgias and paroxysmal symptoms in remitting and progressive multiple sclerosis.

Eriksson M, Ben-Menachem E, Andersen O.

Institute of Clinical Neuroscience, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden.

The occurrence of a first epileptic seizure, spinal or brainstem paroxysmal symptom and cranial neuralgia during 25 years after onset was studied in a population-based multiple sclerosis (MS) cohort of 255 patients. Epileptic seizures occurred in 20, paroxysmal symptoms in 11 and cranial (trigeminal, intermedius, retroauricular or occipital) neuralgia in 11 patients. The yearly incidence of epileptic seizures in MS was estimated to be 349(+/-153)/100,000, approximately seven times higher than in the general population. The yearly incidence of a first paroxysmal symptom in the present material was calculated to be 190 cases in 100,000 MS patients, and the yearly incidence of cranial neuralgia was 189 cases in 100,000 MS patients. The epileptic seizures were more frequent during the progressive course than in the relapsing-remitting (RR) course. The frequencies of paroxysmal symptoms and cranial neuralgia did not differ between these two disease courses. A coincidence of epileptic seizures and a decline in cognitive functioning not seen among patients with paroxysmal symptoms was found The relatively late occurrence of epileptic seizures indicates that the frequency of epileptogenesis, known to involve neuronal damage, increases in the later stages of MS.


42: Kayser V, Aubel B, Hamon M, Bourgoin S. Related Articles, 
Abstract -  The antimigraine 5-HT 1B/1D receptor agonists, sumatriptan, zolmitriptan and dihydroergotamine, attenuate pain-related behaviour in a rat model of trigeminal neuropathic pain.
Br J Pharmacol. 2002 Dec;137(8):1287-97.
PMID: 12466238 [PubMed - indexed for MEDLINE]


43: Karpinos M, Teh BS, Zeck O, Carpenter LS, Phan C, Mai WY, Lu HH, Chiu JK, Butler EB, Gormley WB, Woo SY. Related Articles, 
Abstract -  Treatment of acoustic neuroma: stereotactic radiosurgery vs. microsurgery.
Int J Radiat Oncol Biol Phys. 2002 Dec 1;54(5):1410-21.
PMID: 12459364 [PubMed - indexed for MEDLINE]


44: Deseure K, Koek W, Colpaert FC, Adriaensen H. Related Articles, 
Abstract -  The 5-HT(1A) receptor agonist F 13640 attenuates mechanical allodynia in a rat model of trigeminal neuropathic pain.
Eur J Pharmacol. 2002 Dec 5;456(1-3):51-7.
PMID: 12450569 [PubMed - indexed for MEDLINE]


45: Friedrich RE, Giese M, Mautner VF, Schmelzle R, Scheuer HA. Related Articles, 
Abstract -  [Abnormalities of the maxillary sinus in type 1 neurofibromatosis]
Mund Kiefer Gesichtschir. 2002 Sep;6(5):363-7. German.
PMID: 12448243 [PubMed - indexed for MEDLINE]


46: Spiegelmann R, Nissim O, Menhel J, Alezra D, Pfeffer MR. Related Articles, 
Abstract -  Linear accelerator radiosurgery for meningiomas in and around the cavernous sinus.
Neurosurgery. 2002 Dec;51(6):1373-79; discussion 1379-80.
PMID: 12445342 [PubMed - indexed for MEDLINE]


47: Devulder JE. Related Articles, 
Abstract -  Postherpetic ophthalmic neuralgia.
Bull Soc Belge Ophtalmol. 2002;(285):19-23. Review.
PMID: 12442339 [PubMed - indexed for MEDLINE]

Postherpetic ophthalmic neuralgia.

Devulder JE.

Ghent University Hospital, Department of Anesthesia-Section Pain Clinic, B-9000 Ghent, Belgium. jacques.devulder@rug.ac.be

Postherpetic ophthalmic neuralgia is the final stage of a varicella zoster infection. Many years after chickenpox infection, patients can develop herpes zoster in one or more specific dermatomal regions. The ophthalmic branch of the trigeminal nerve and the thoracic nerves are most commonly affected. Younger patients are less prone to postherpetic neuralgia than the older. Patients with a depression in cell-mediated immunity are more susceptible to develop postherpetic pain. Postherpetic ophthalmic neuralgia is a neuropathic pain and can be treated by anticonvulsants and tricyclic antidepressants. Neurodestructive procedures are not recommended as they enhance destruction and neuropathic pain. Sympathetic nerve blocks can be helpful. Neurostimulation is the last therapeutic resort.

Publication Types:

* Review
* Review, Tutorial

48: Cabaleiro J. Related Articles, 
No abstract - Assessing and treating neuropathic pain.
Home Healthc Nurse. 2002 Nov;20(11):718-23; quiz 724. No abstract available.
PMID: 12442041 [PubMed - indexed for MEDLINE]


49: Takeda M, Ikeda M, Tanimoto T, Lipski J, Matsumoto S. Related Articles, 
Abstract -  Changes of the excitability of rat trigeminal root ganglion neurons evoked by alpha(2)-adrenoreceptors.
Neuroscience. 2002;115(3):731-41.
PMID: 12435412 [PubMed - indexed for MEDLINE]


50: Scardina GA, Mazzullo M, Messina P. Related Articles, 
Abstract -  [Early diagnosis of progressive systemic sclerosis: the role of oro-facial phenomena]
Minerva Stomatol. 2002 Jul-Aug;51(7-8):311-7. Review. Italian.
PMID: 12434126 [PubMed - indexed for MEDLINE]


51: Vitek L, Tettenborn B. Related Articles, 
No abstract - Cavernous angioma in the brachium pontis presenting with trigeminal neuralgia: a case report.
Eur Neurol. 2002;48(4):226-8. No abstract available.
PMID: 12422074 [PubMed - indexed for MEDLINE]


52: Volvoikar P, Patil S, Dinkar A. Related Articles, 
Abstract -  Tooth exfoliation, osteonecrosis and neuralgia following herpes zoster of trigeminal nerve.
Indian J Dent Res. 2002 Jan-Mar;13(1):11-4. Review.
PMID: 12420562 [PubMed - indexed for MEDLINE]

Tooth exfoliation, osteonecrosis and neuralgia following herpes zoster of trigeminal nerve.

Volvoikar P, Patil S, Dinkar A.

Department of Oral Medicine & Radiology, Goa Dental College, Bambolim, Goa-403202, India.

A case of herpes zoster of the trigeminal nerve with complications of osteonecrosis and neuralgia in the absence of local or systemic predisposing factors is presented. The literature is reviewed and the role of varicella zoster virus in the pathology of tooth exfoliation and osteonecrosis is discussed.

Publication Types:

* Review
* Review, Tutorial

53: Micheli F, Scorticati MC, Raina G. Related Articles, 
Abstract -  Beneficial effects of botulinum toxin type a for patients with painful tic convulsif.
Clin Neuropharmacol. 2002 Sep-Oct;25(5):260-2.
PMID: 12410057 [PubMed - indexed for MEDLINE]


54: Dufour SK. Related Articles, 
Abstract -  An unusual case of stabbing eye pain: a case report and review of trigeminal neuralgia.
Optometry. 2002 Oct;73(10):626-34. Review.
PMID: 12408549 [PubMed - indexed for MEDLINE]


55: Edwards RJ, Clarke Y, Renowden SA, Coakham HB. Related Articles, 
Abstract -  Trigeminal neuralgia caused by microarteriovenous malformations of the trigeminal nerve root entry zone: symptomatic relief following complete excision of the lesion with nerve root preservation.
J Neurosurg. 2002 Oct;97(4):874-80.
PMID: 12405376 [PubMed - indexed for MEDLINE]


56: Galer BS. Related Articles, 
No abstract - Effectiveness and safety of lidocaine patch 5%.
J Fam Pract. 2002 Oct;51(10):867-8; author reply 868. No abstract available.
PMID: 12401158 [PubMed - indexed for MEDLINE]


57: Huang H. Related Articles, 
No abstract - Combined use of the points shenmai and zhaohai for treatment of craniofacial diseases.
J Tradit Chin Med. 2002 Sep;22(3):221-3. No abstract available.
PMID: 12400435 [PubMed - indexed for MEDLINE]


58: Arias M, Iglesias A, Vila O, Brasa J, Conde C. Related Articles, 
Abstract -  MR imaging findings of neurosarcoidosis of the gasserian ganglion: an unusual presentation.
Eur Radiol. 2002 Nov;12(11):2723-5.
PMID: 12386763 [PubMed - indexed for MEDLINE]


59: Unger F, Walch C, Schrottner O, Eustacchio S, Sutter B, Pendl G. Related Articles, 
Abstract -  Cranial nerve preservation after radiosurgery of vestibular schwannomas.
Acta Neurochir Suppl. 2002;84:77-83.
PMID: 12379008 [PubMed - indexed for MEDLINE]


60: Kondo A. Related Articles, 
Abstract -  Microvascular decompression surgery for trigeminal neuralgia.
Stereotact Funct Neurosurg. 2001;77(1-4):187-9.
PMID: 12378075 [PubMed - indexed for MEDLINE]

Microvascular decompression surgery for trigeminal neuralgia.

Kondo A.

Department of Neurosurgery, Shiroyama Hospital, Furuiti, Habikino City, Osaka, Japan.

Long-term follow-up data were analyzed to evaluate the surgical results of microvascular decompression (MVD). Among 1,324 patients with trigeminal neuralgia (TGN), who underwent MVD between 1976 and 2000, a consecutive 281 patients were followed and studied for 5-20 years as of the year of 1997. When the data were analyzed and compared in two groups (A: 1976-1986, B: 1987-1991), the postoperative cure rate increased from 92.9 to 96.7%, satisfaction rate with the results of MVD increased from 80.3 to 82.5%, incomplete cure rate decreased from 7.1 to 3.3%, and recurrence rate decreased from 10.2 to 6.5%. Advances in surgical techniques may have increased the success rate in Group B. Copyright 2002 S. Karger AG, Basel

61: Simmons A. 
Abstract -  Clinical manifestations and treatment considerations of herpes simplex virus infection.
J Infect Dis. 2002 Oct 15;186 Suppl 1:S71-7. Review.
PMID: 12353190 [PubMed - indexed for MEDLINE]

Clinical manifestations and treatment considerations of herpes simplex virus infection.

Simmons A.

Children's Hospital, University of Texas Medical Branch at Galveston, Galveston, TX 77555-0373, USA. ansimmon@utmb.edu

Herpes simplex viruses (HSV) types 1 and 2 cause infections manifesting as dermatologic, immunologic, and neurologic disorders. Some of the most important manifestations and complications of HSV infection are considered here in a neuroanatomic context. This discussion should aid in understanding the pathogenesis and, in some cases, diagnosis and management of associated HSV-related diseases. The sensory nervous system, rather than skin and mucous membranes, is the primary target of HSV infection. With the intention of extending the benefits of acyclovir, valacyclovir is now being explored in a number of HSV-related conditions. This review extends contemporary thinking about how new antiherpetic drugs might be put to greater therapeutic use in the future.

Publication Types:

* Review
* Review, Tutorial


62: Sterkers Y, Botterel F, Nicolas M, Bouree P. 
No abstract - [Herpes zoster of the maxillary branch of the trigeminal nerve]
Presse Med. 2002 Aug 24;31(27):1270. French. No abstract available.
PMID: 12238275 [PubMed - indexed for MEDLINE]


63: Forssell H, Jaaskelainen S, Tenovuo O, Hinkka S. 
Abstract -  Sensory dysfunction in burning mouth syndrome.
Pain. 2002 Sep;99(1-2):41-7.
PMID: 12237182 [PubMed - indexed for MEDLINE]

Sensory dysfunction in burning mouth syndrome.

Forssell H, Jaaskelainen S, Tenovuo O, Hinkka S.

Department of Oral Diseases, Turku University Central Hospital, Lemminkaisenkatu 2, FIN-20520 Turku, Finland. heli.forssell@tyks.fi

Our preliminary observations on a small group of burning mouth syndrome (BMS) patients indicated a change in the non-nociceptive, tactile sensory function in BMS and provided evidence for the hypothesis of a neuropathic etiology of BMS. In the present clinical study on a group of 52 BMS patients, we used quantitative sensory tests (QST) in addition to the blink reflex (BR) recordings in order to gain further insight into the neural mechanisms of BMS pain. Based on electrophysiologic findings, the BMS patients could be grouped into four different categories: (1) The results of the BR were suggestive of brainstem pathology or peripheral trigeminal neuropathy in ten (19%) patients. In most of the cases, the abnormalities in the BR seemed to represent subclinical changes of the trigeminal system. (2) Increased excitability of the BR was found in the form of deficient habituation of the R2 component of the BR in 11 (21%) of the patients. Two of these patients also showed signs of warm allodynia in QST. (3) One or more of the sensory thresholds were abnormal indicating thin fiber dysfunction in altogether 35 patients (76%) out of the 46 tested with QST. Thirty-three of these patients showed signs of hypoesthesia. (4) There were only five patients with normal findings in both tests. The present findings with strong evidence for neuropathic background in BMS will hopefully provide insights for new therapeutic strategies. Copyright 2002 International Association for the Study of Pain


64: Akimoto H, Nagaoka T, Nariai T, Takada Y, Ohno K, Yoshino N. 
Abstract -  Preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia by use of three-dimensional reconstruction from two types of high-resolution magnetic resonance imaging.
Neurosurgery. 2002 Oct;51(4):956-61; discussion 961-2.
PMID: 12234403 [PubMed - indexed for MEDLINE]

Preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia by use of three-dimensional reconstruction from two types of high-resolution magnetic resonance imaging.

Akimoto H, Nagaoka T, Nariai T, Takada Y, Ohno K, Yoshino N.

Department of Neurosurgery, Tokyo Medical and Dental University, Japan. akinsrg@plum.ocn.ne.jp

OBJECTIVE: To assess the value of three-dimensional (3-D) images reconstructed from 3-D constructive interference in steady state (3-D-CISS) and 3-D fast inflow with steady-state precession (3-D-FISP) images for the visualization of neurovascular compression in patients with trigeminal neuralgia. METHODS: Twenty-four consecutive patients with trigeminal neuralgia underwent preoperative 3-D-FISP and 3-D-CISS imaging. 3-D reconstruction of nerves and vessels was performed with the use of a volume-rendering method. We compared the 3-D reconstructed images with intraoperative findings. RESULTS: 3-D-CISS and 3-D-FISP images scanned from the same position clearly delineated the trigeminal nerve and vessels. 3-D reconstructed images showed the spatial relationship between the trigeminal nerve and causative vessels. The responsible arteries were identified from the 3-D reconstructed images, which closely simulated the microscopic operative view. CONCLUSION: 3-D reconstructions from two types of high-resolution magnetic resonance images (3-D-CISS and 3-D-FISP) are very useful for creating preoperative simulations and in deciding whether to perform surgery in patients with trigeminal neuralgia.


65: Zakrzewska JM. 
No abstract - Trigeminal neuralgia.
Clin Evid. 2002 Jun;(7):1221-31. Review. No abstract available.
PMID: 12230739 [PubMed - indexed for MEDLINE]


66: Chaudhary P, Baumann T. 
Abstract -  Expression of VPAC2 receptor and PAC1 receptor splice variants in the trigeminal ganglion of the adult rat.
Brain Res Mol Brain Res. 2002 Aug 15;104(2):137-42.
PMID: 12225867 [PubMed - indexed for MEDLINE]


67: Unger F, Walch C, Papaefthymiou G, Eustacchio S, Feichtinger K, Quehenberger F, Pendl G. 
Abstract -  Long term results of radiosurgery for vestibular schwannomas.
Zentralbl Neurochir. 2002;63(2):52-8.
PMID: 12224030 [PubMed - indexed for MEDLINE]


68: Allanore Y, Zuber M, Kahan A. 
Abstract -  Brachial plexopathy associated with systemic sclerosis.
Clin Rheumatol. 2002 Sep;21(5):401-2.
PMID: 12223990 [PubMed - indexed for MEDLINE]


69: Gregoire A, Clair C, Delabrousse E, Aubry R, Boulahdour Z, Kastler B. 
Abstract -  [CT guided neurolysis of the sphenopalatine ganglion for management of refractory trigeminal neuralgia]
J Radiol. 2002 Sep;83(9 Pt 1):1082-4. French.
PMID: 12223918 [PubMed - indexed for MEDLINE]


70: Fiske J, Griffiths J, Thompson S. 
Abstract -  Multiple sclerosis and oral care.
Dent Update. 2002 Jul-Aug;29(6):273-83. Review.
PMID: 12222018 [PubMed - indexed for MEDLINE]

Multiple sclerosis and oral care.

Fiske J, Griffiths J, Thompson S.

Guy's, King's and St Thomas' Dental Institute of King's College, London.

Multiple sclerosis is a complex neurological condition affecting sensory and motor nerve transmission. Its progression and symptoms are unpredictable and vary from person to person as well as over time. Common early symptoms include visual disturbances, facial pain or trigeminal neuralgia and paraesthesia or numbness of feet, legs, hands and arms. These, plus symptoms of spasticity, spasms, tremor, fatigue, depression and progressive disability, impact on the individual's ability to maintain oral health, cope with dental treatment and access dental services. Also, many of the medications used in the symptomatic management of the condition have the potential to cause dry mouth and associated oral disease. There is no cure for multiple sclerosis, and treatment focuses on prevention of disability and maintenance of quality of life. Increasingly a multi-disciplinary team approach is used where the individual, if appropriate his/her carer, and the specialist nurse are key figures. The dental team plays an essential role in ensuring that oral health impacts positively on general health.

Publication Types:

* Review
* Review, Tutorial


71: Freudenstein D, Wagner A, Gurvit O, Bartz D, Duffner F. 
Abstract -  Simultaneous virtual representation of both vascular and neural tissue within the subarachnoid space of the basal cistern--technical note.
Med Sci Monit. 2002 Sep;8(9):MT153-8.
PMID: 12218952 [PubMed - indexed for MEDLINE]


72: Uchino A, Sawada A, Hirakawa N, Totoki T, Kudo S. 
Abstract -  Congenital absence of the internal carotid artery diagnosed during investigation of trigeminal neuralgia.
Eur Radiol. 2002 Sep;12(9):2339-42.
PMID: 12195492 [PubMed - indexed for MEDLINE]


73: Hung CM, Kang HM, Shen CH, Yang TC, Wu CC, Ho WM. 
Abstract -  Contralateral neurologic deficits following microvascular decompression surgery--a case report.
Acta Anaesthesiol Sin. 2002 Jun;40(2):91-5.
PMID: 12194397 [PubMed - indexed for MEDLINE]


74: Smith RR, Lavassani A, Zachow S, Wahl D, Mandybur G, Patrick B. 
No abstract - The gamma knife for relief of trigeminal neuralgia.
J Miss State Med Assoc. 2002 Jul;43(7):205-7. No abstract available.
PMID: 12189910 [PubMed - indexed for MEDLINE]


75: Pollock BE, Phuong LK, Gorman DA, Foote RL, Stafford SL. 
Abstract -  Stereotactic radiosurgery for idiopathic trigeminal neuralgia.
J Neurosurg. 2002 Aug;97(2):347-53.
PMID: 12186463 [PubMed - indexed for MEDLINE]


76: Wrobel-Wisniewska G, Kasprzak P, Zawirski M. 
Abstract -  [Sixteen-year experience in the treatment of trigeminal neuralgia by percutaneous retrogasserian thermorhizotomy]
Neurol Neurochir Pol. 2002 May-Jun;36(3):471-9. Polish.
PMID: 12185803 [PubMed - indexed for MEDLINE]


[Sixteen-year experience in the treatment of trigeminal neuralgia by percutaneous retrogasserian thermorhizotomy]

[Article in Polish]

Wrobel-Wisniewska G, Kasprzak P, Zawirski M.

Katedry i Kliniki Neurochirurgii AM w Lodzi.

The authors present a series of 143 consecutive patients with trigeminal neuralgia who were treated with percutaneous retrogasserian thermorhizotomy between 1984 and 2000. Long time results (follow-up of 16 years) revealed full pain relief in 80% of patients, mainly in those with postoperative sensory deficit, 16% suffered pain recurrence and required additional treatment.

PMID: 12185803 [PubMed - indexed for MEDLINE]


77: Harsh GR, Thornton AF, Chapman PH, Bussiere MR, Rabinov JD, Loeffler JS. 
Abstract -  Proton beam stereotactic radiosurgery of vestibular schwannomas.
Int J Radiat Oncol Biol Phys. 2002 Sep 1;54(1):35-44.
PMID: 12182972 [PubMed - indexed for MEDLINE]


78: Unger F, Walch C, Papaefthymiou G, Feichtinger K, Trummer M, Pendl G. 
Abstract -  Radiosurgery of residual and recurrent vestibular schwannomas.
Acta Neurochir (Wien). 2002 Jul;144(7):671-6; discussion 676-7.
PMID: 12181700 [PubMed - indexed for MEDLINE]


79: Wang CJ, Howng SL. 
Abstract -  Trigeminal neuralgia caused by nasopharyngeal carcinoma with skull base invasion--a case report.
Kaohsiung J Med Sci. 2001 Dec;17(12):630-2.
PMID: 12168498 [PubMed - indexed for MEDLINE]


80: Theodosopoulos PV, Marco E, Applebury C, Lamborn KR, Wilson CB. 
Abstract -  Predictive model for pain recurrence after posterior fossa surgery for trigeminal neuralgia.
Arch Neurol. 2002 Aug;59(8):1297-302.
PMID: 12164727 [PubMed - indexed for MEDLINE]

81: Watanabe J, Mizunuma N, Aruga A, Oguchi M, Hatake K. Related Articles, 
No abstract - Trigeminal neuralgia caused by lymphomatous compression at oval foramen.
Eur J Haematol. 2002 May;68(5):323. No abstract available.
PMID: 12144542 [PubMed - indexed for MEDLINE]


82: Ranganath HN. Related Articles, 
No abstract - Treatment of trigeminal neuralgia: letter to editor.
Neurol India. 2002 Jun;50(2):231. No abstract available.
PMID: 12134205 [PubMed - indexed for MEDLINE]


83: Qi S, Yu X, Li S, Zhou D, Liu Z. Related Articles, 
Abstract -  [Neuropathy in nearby cranial nerves after acoustic schwannoma gamma knife radiosurgery, a follow-up study]
Zhonghua Yi Xue Za Zhi. 2002 May 10;82(9):637-9. Chinese.
PMID: 12133489 [PubMed - indexed for MEDLINE]


84: Wehrmann J. Related Articles, 
No abstract - [Comment on the contribution by RE Schopf et a.: "Neurotrophic ulcer as a late sequela of trigeminal exharesis"]
Hautarzt. 2002 Jun;53(6):438. German. No abstract available.
PMID: 12132303 [PubMed - indexed for MEDLINE]


85: Zakrzewska JM. Related Articles, 
No abstract - Facial pain: neurological and non-neurological.
J Neurol Neurosurg Psychiatry. 2002 Jun;72 Suppl 2:ii27-ii32. Review. No abstract available.
PMID: 12122200 [PubMed - indexed for MEDLINE]


86: Matharu MS, Goadsby PJ. Related Articles, 
No abstract - Trigeminal autonomic cephalgias.
J Neurol Neurosurg Psychiatry. 2002 Jun;72 Suppl 2:ii19-ii26. Review. No abstract available.
PMID: 12122199 [PubMed - indexed for MEDLINE]


87: Nicoletti GF, Platania N, Furnari N, Barbagallo G, Albanese V. Related Articles, 
Abstract -  Trigeminal palsy caused by triventricular hydrocephalus. A case report.
J Neurosurg Sci. 2002 Mar;46(1):32-3; discussion 33-4.
PMID: 12118222 [PubMed - indexed for MEDLINE]


88: Aramideh M, Ongerboer de Visser BW. Related Articles, 
Abstract -  Brainstem reflexes: electrodiagnostic techniques, physiology, normative data, and clinical applications.
Muscle Nerve. 2002 Jul;26(1):14-30. Review.
PMID: 12115945 [PubMed - indexed for MEDLINE]


89: Farber RE. Related Articles, 
No abstract - Nasally triggered headache.
Neurology. 2002 Jul 9;59(1):151; author reply 151. No abstract available.
PMID: 12105334 [PubMed - indexed for MEDLINE]


90: Panciera RJ, Ritchey JW, Baker JE, DiGregorio M. Related Articles, 
Abstract -  Trigeminal and polyradiculoneuritis in a dog presenting with masticatory muscle atrophy and Horner's syndrome.
Vet Pathol. 2002 Jan;39(1):146-9.
PMID: 12102209 [PubMed - indexed for MEDLINE]


91: Boes CJ, Capobianco DJ, Matharu MS, Goadsby PJ. Related Articles, 
Abstract -  Wilfred Harris' early description of cluster headache.
Cephalalgia. 2002 May;22(4):320-6.
PMID: 12100097 [PubMed - indexed for MEDLINE]


92: Pareja JA, Baron M, Gili P, Yanguela J, Caminero AB, Dobato JL, Barriga FJ, Vela L, Sanchez-del-Rio M. Related Articles, 
Abstract -  Objective assessment of autonomic signs during triggered first division trigeminal neuralgia.
Cephalalgia. 2002 May;22(4):251-5.
PMID: 12100085 [PubMed - indexed for MEDLINE]

Objective assessment of autonomic signs during triggered first division trigeminal neuralgia.

Pareja JA, Baron M, Gili P, Yanguela J, Caminero AB, Dobato JL, Barriga FJ, Vela L, Sanchez-del-Rio M.

Department of Neurology, Fundacion Hospital Alcorcon, Madrid, Spain. japareja@fhalcorcon.es

A total of 26 episodes of V-1 trigeminal neuralgia attacks have been recorded in two female patients. Autonomic phenomena were assessed according to a semiquantitative scale. Attacks lasted 17 +/- 5 s. Mild lacrimation without conjunctival hyperaemia, rhinorrhea or ptosis was observed, even in relatively long lasting episodes. This is in clear contradiction with SUNCT (shortlasting, unilateral, neuralgiform headache with conjunctival injection, tearing and rhinorrhea) attacks that are always dramatically accompanied by both lacrimation and conjunctival injection of the symptomatic side from the very onset of symptoms. Carbamazepine provided complete and sustained relief of symptoms in both patients. Herein we will show differential autonomic features of V-1 trigeminal neuralgia vs. SUNCT that will both aid the clinician to distinguish both syndromes and stress that both entities are nosologicaly different.


93: Cha ST, Eby JB, Katzen JT, Shahinian HK. Related Articles, 
Abstract -  Trigeminocardiac reflex: a unique case of recurrent asystole during bilateral trigeminal sensory root rhizotomy.
J Craniomaxillofac Surg. 2002 Apr;30(2):108-11.
PMID: 12069514 [PubMed - indexed for MEDLINE]


94: Teive HA, Piovesan EJ, Germiniani FM, Camargo CH, Sa D, Scola RH, Werneck LC. Related Articles, 
Abstract -  Hemimasticatory spasm treated with botulinum toxin: case report.
Arq Neuropsiquiatr. 2002 Jun;60(2-A):288-9.
PMID: 12068362 [PubMed - indexed for MEDLINE]


95: Vaideanu D, Fraser K, Deady JP. Related Articles, 
No abstract - Just another corneal abrasion?
Lancet. 2002 Jun 1;359(9321):1916. No abstract available.
PMID: 12057555 [PubMed - indexed for MEDLINE]


96: Pradel W, Hlawitschka M, Eckelt U, Herzog R, Koch K. Related Articles, 
Abstract -  Cryosurgical treatment of genuine trigeminal neuralgia.
Br J Oral Maxillofac Surg. 2002 Jun;40(3):244-7.
PMID: 12054718 [PubMed - indexed for MEDLINE]


97: Regis J. Related Articles, 
No abstract - High-dose trigeminal neuralgia radiosurgery associated with increased risk of trigeminal nerve dysfunction.
Neurosurgery. 2002 Jun;50(6):1401-2; author reply 1402-3. No abstract available.
PMID: 12051192 [PubMed - indexed for MEDLINE]


98: Umino M, Kohase H, Ideguchi S, Sakurai N. Related Articles, 
Abstract -  Long-term pain control in trigeminal neuralgia with local anesthetics using an indwelling catheter in the mandibular nerve.
Clin J Pain. 2002 May-Jun;18(3):196-9.
PMID: 12048422 [PubMed - indexed for MEDLINE]


99: Black DF, Dodick DW. Related Articles, 
Abstract -  Two cases of medically and surgically intractable SUNCT: a reason for caution and an argument for a central mechanism.
Cephalalgia. 2002 Apr;22(3):201-4.
PMID: 12047459 [PubMed - indexed for MEDLINE]

Two cases of medically and surgically intractable SUNCT: a reason for caution and an argument for a central mechanism.

Black DF, Dodick DW.

Mayo Clinic, Rochester, Minnesota 55905, USA.

We report two cases of SUNCT that demonstrate the medically and surgically refractory nature of this disorder and support the hypothesis that the causative 'lesion' lies within the central nervous system. After both patients had failed medical therapies, the first underwent a glycerol rhizotomy, gammaknife radiosurgery and microvascular decompression of the trigeminal nerve. The second patient underwent gammaknife radiosurgery of the trigeminal root exit zone and two microvascular decompression surgeries. Neither patient benefited from these procedures. Currently, the first patient suffers from anaesthesia dolorosa and the second patient from unilateral deafness, chronic vertigo and dysequilibrium as a result of surgical trauma. These cases of SUNCT highlight the uncertainty regarding the role of surgery given the potential for significant morbidity. These cases also suggest that SUNCT originates and may be maintained from within the CNS and this central locus explains why SUNCT is not typically amenable to interventions aimed at the peripheral portion of the trigeminal nerve.


100: Benoliel R, Eliav E, Tal M. Related Articles, 
Abstract -  Strain-dependent modification of neuropathic pain behaviour in the rat hindpaw by a priming painful trigeminal nerve injury.
Pain. 2002 Jun;97(3):203-12.
PMID: 12044617 [PubMed - indexed for MEDLINE]

101: Mayhew PD, Bush WW, Glass EN. 
Abstract -  Trigeminal neuropathy in dogs: a retrospective study of 29 cases (1991-2000).
J Am Anim Hosp Assoc. 2002 May-Jun;38(3):262-70.
PMID: 12022413 [PubMed - indexed for MEDLINE]


102: Das B, Saha SP. 
Abstract -  Trigeminal neuralgia: current concepts and management.
J Indian Med Assoc. 2001 Dec;99(12):704-9. Review.
PMID: 12022221 [PubMed - indexed for MEDLINE]

Trigeminal neuralgia: current concepts and management.

Das B, Saha SP.

Bangur Institute of Neurology, Kolkata.

Trigeminal neuralgia is the most frequent cranial neuralgia, the incidence being 1 per 1,000,00 persons per year. It presents with stabbing pain often in the distribution of the mandibular and maxillary divisions of the trigeminal nerve. An accurate history of pain is important in the diagnosis of trigeminal neuralgia. A patient with tic douloureux and no neurological abnormality on clinical examination does not need diagnostic tests. The available options for management of trigeminal neuralgia are: Pharmacotherapy, destructive procedures and non-destructive procedures. The pharmacotherapy includes (i) monotherapy with one anticonvulsant, (ii) combined therapy with more than one anticonvulsant, (iii) add-on therapy with newer drugs and (iv) polytherapy with anticonvulsant + add-on drugs + antidepressants/anxiolytics. Destructive procedures include (i) non-surgical methods--injections along trigeminal pathways, percutaneous trigeminal radiofrequency thermocoagulation and (ii) surgical methods--trigeminal branch avulsion or peripheral neurectomy, avulsion of trigeminal nerve, trigeminal tractotomy, radiosurgery. Though various modalities of treatment are available for the management of trigeminal neuralgia, pharmacotherapy with carbamazepine still remains the first line of treatment. The alternative approach followed at most centres is percuatenous Gasserian rhizolysis (chemical/radiofrequency thermal) or microvascular decompression.

Publication Types:

* Review
* Review, Tutorial


103: Brisman R, Khandji AG, Mooij RB. 
Abstract -  Trigeminal Nerve-Blood Vessel Relationship as Revealed by High-resolution Magnetic Resonance Imaging and Its Effect on Pain Relief after Gamma Knife Radiosurgery for Trigeminal Neuralgia.
Neurosurgery. 2002 Jun;50(6):1261-6, discussion 1266-7.
PMID: 12015844 [PubMed - indexed for MEDLINE]

Trigeminal Nerve-Blood Vessel Relationship as Revealed by High-resolution Magnetic Resonance Imaging and Its Effect on Pain Relief after Gamma Knife Radiosurgery for Trigeminal Neuralgia.

Brisman R, Khandji AG, Mooij RB.

Department of Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York Presbyterian Hospital, Columbia Presbyterian Medical Center, New York, New York 10032-2699, USA. rb36@columbia.edu

OBJECTIVE: Blood vessel (BV) compression of the trigeminal nerve (Cranial Nerve [CN] V) is a common cause of trigeminal neuralgia (TN). High-resolution magnetic resonance imaging scans obtained during gamma knife radiosurgery (GKRS) in patients with TN may be used to analyze the BV-CN V relationship. Follow-up data from a large series of patients treated with GKRS for TN were used to provide information regarding the BV-CN V relationship and pain relief. METHODS: T1-weighted, axial 1-mm-thick volume acquisition magnetic resonance imaging scans were obtained through the area of CN V at its exit from the brainstem after injection of 15 ml of gadolinium. The BV-CN V relationship on the symptomatic side that was treated with GKRS was categorized into the following groups: Group 1 (no close relationship), Group 2 (BV close to CN V but not touching it), and Groups 3 and higher (BV-CN V contact). RESULTS: A total of 181 symptomatic nerves were studied in 179 patients with TN who were treated with GKRS. In BV-CN V Groups 1, 2, and 3 and higher, respectively, were 43 sides (24%), 31 sides (17%), and 107 sides (59%). In 100 sides where there was no surgical procedure before GKRS, 50% or greater pain relief was more likely in those with BV-CN V contact (51 [88%] of 58 sides) than in those without BV-CN V (29 [69%] of 42 sides) (P = 0.024). BV-CN V contact was observed more often in men (55 [69%] of 80 sides) than in women (52 [52%] of 101 sides) (P = 0.023) and more often in patients who had unilateral TN (104 [62%] of 169 patients) rather than bilateral TN (2 [20%] of 10 patients) (P = 0.016). CONCLUSION: In patients who have not undergone previous surgery for TN, BV-CN V contact revealed by high-resolution magnetic resonance imaging may indicate a particularly favorable response to GKRS.


104: Shigeno T, Kumai J, Endo M, Oya S, Hotta S. 
Abstract -  Snare technique of vascular transposition for microvascular decompression--technical note.
Neurol Med Chir (Tokyo). 2002 Apr;42(4):184-9; discussion 190.
PMID: 12013673 [PubMed - indexed for MEDLINE]


105: Desai K, Nadkarni T, Bhayani R, Goel A. 
Abstract -  Cerebellopontine angle epidermoid tumor presenting with 'tic convulsif' and tinnitus--case report.
Neurol Med Chir (Tokyo). 2002 Apr;42(4):162-5.
PMID: 12013668 [PubMed - indexed for MEDLINE]


106: Zheng LG, Xu DS, Kang CS, Zhang ZY, Li YH, Zhang YP, Liu D, Jia Q. 
Abstract -  Stereotactic radiosurgery for primary trigeminal neuralgia using the Leksell Gamma unit.
Stereotact Funct Neurosurg. 2001;76(1):29-35.
PMID: 12007276 [PubMed - indexed for MEDLINE]


107: Konzelman JL Jr, Herman WW, Comer RW. 
Abstract -  Enigmatic pain referred to the teeth and jaws.
Gen Dent. 2001 Mar-Apr;49(2):182-6; quiz 187-8.
PMID: 12004699 [PubMed - indexed for MEDLINE]


Enigmatic pain referred to the teeth and jaws.

Konzelman JL Jr, Herman WW, Comer RW.

A number of obscure syndromes can mimic dental or jaw pain in the absence of pathosis within these structures. This enigmatic dental pain includes conditions such as pretrigeminal neuralgia, complex regional pain syndrome, temporal tendinitis, and carotodynia. Each of these syndromes is described through a pertinent case report to illustrate appropriate diagnosis and treatment.


108: DuPont JS Jr. 
Abstract -  Neuritic toothache.
Gen Dent. 2001 Mar-Apr;49(2):178-81.
PMID: 12004698 [PubMed - indexed for MEDLINE]


Neuritic toothache.

DuPont JS Jr.

Diagnosing and managing neuropathic pain with associated sensory aberrations can be aggravating and frustrating for both the dentist and the patient. The teeth and intraoral and extraoral tissues can be affected if neuritis is located in the maxillary or mandibular nerve branches. Dentists should be aware of a neuritic etiology for tooth pain because an incorrect diagnosis can lead to ineffective and unnecessary dental work.


109: Shankland WE 2nd. 
Abstract -  Differential diagnosis of two disorders that produce common orofacial pain symptoms.
Gen Dent. 2001 Mar-Apr;49(2):150-5. Review.
PMID: 12004693 [PubMed - indexed for MEDLINE]

Differential diagnosis of two disorders that produce common orofacial pain symptoms.

Shankland WE 2nd.

Severe orofacial pain often is diagnosed as trigeminal neuralgia, with little distinction made as to which type--typical or atypical. In addition, osteonecrosis of the jaws quite often produces symptoms which mimic trigeminal neuralgia. Unless diagnosed correctly, a patient suffering from a condition of "dead bone" may be referred for unnecessary neurosurgery. The general dentist often is the one doctor who can make the proper diagnosis and guide the patient toward the proper treatment.

Publication Types:

* Review
* Review, Tutorial


110: Omoto M, Fukusako T, Ikuta N, Ogasawara J, Kawai M, Negoro K, Morimatsu M. 
Abstract -  - [A case presenting with Raeder's syndrome-like symptoms due to vertebral artery aneurysm]
Rinsho Shinkeigaku. 2001 Oct;41(10):701-3. Japanese.
PMID: 11993193 [PubMed - indexed for MEDLINE]


111: [No authors listed] 
No abstract - Trigeminal neuralgia in dentistry.
Dent Implantol Update. 2000 Feb;11(2):15. No abstract available.
PMID: 11992935 [PubMed - indexed for MEDLINE]


112: Lopes PG, Castro ES Jr, Lopes LH. 
Abstract -  - Trigeminal neuralgia in children: two case reports.
Pediatr Neurol. 2002 Apr;26(4):309-10.
PMID: 11992761 [PubMed - indexed for MEDLINE]


113: Yamada K, Miyamoto S, Takayama M, Nagata I, Hashimoto N, Ikada Y, Kikuchi H. 
Abstract -  - Clinical application of a new bioabsorbable artificial dura mater.
J Neurosurg. 2002 Apr;96(4):731-5.
PMID: 11990814 [PubMed - indexed for MEDLINE]


114: Holt DJ, Foy PM, Field EA. 
Abstract -  - Orofacial paraesthesia: an unusual presentation of acoustic neuroma.
Dent Update. 2002 Apr;29(3):141-2.
PMID: 11989391 [PubMed - indexed for MEDLINE]


115: Kolasa P, Palka Z, Wegrzyn Z. 
Abstract -  - [Retrospective assessment of bilateral trigeminal neuralgia treatment]
Neurol Neurochir Pol. 2001 Nov-Dec;35(6):1063-9. Polish.
PMID: 11987702 [PubMed - indexed for MEDLINE]


116: Katsarava Z, Frings M, Kaube H, Diener HC, Limmroth V. 
No abstract - Selective damage of trigeminal Adelta fibres in Raeder's syndrome following dissection of the ICA detected by a nociceptive blink reflex.
Cephalalgia. 2002 Mar;22(2):151-3. No abstract available.
PMID: 11972586 [PubMed - indexed for MEDLINE]


117: Green AL, Yeh JS, Brydon HL, Carey MP. 
No abstract - Cellular schwannoma of the posterior fossa.
J Neurol Neurosurg Psychiatry. 2002 May;72(5):677-8. No abstract available.
PMID: 11971068 [PubMed - indexed for MEDLINE]


118: Gupta V, Singh AK, Kumar S, Sinha S. 
      - Familial trigeminal neuralgia.
Neurol India. 2002 Mar;50(1):87-9. Review.
PMID: 11960159 [PubMed - indexed for MEDLINE]


119: Pollock BE, Foote RL, Stafford SL. 
Abstract - Stereotactic radiosurgery: the preferred management for patients with nonvestibular schwannomas?
Int J Radiat Oncol Biol Phys. 2002 Mar 15;52(4):1002-7.
PMID: 11958895 [PubMed - indexed for MEDLINE]


120: Stranjalis G, Sakas DE. 
No abstract - Post-traumatic transient bilateral trigeminal neuropathy.
Acta Neurochir (Wien). 2002 Mar;144(3):307-8; discussion 308. No abstract available.
PMID: 11956947 [PubMed - indexed for MEDLINE]


Return to "Giving Something Back"