{"id":26086,"date":"2019-03-25T10:52:05","date_gmt":"2019-03-25T10:52:05","guid":{"rendered":"http:\/\/biomedpharmajournal.org\/?p=26086"},"modified":"2020-04-23T10:05:34","modified_gmt":"2020-04-23T10:05:34","slug":"role-of-magnetic-resonance-imaging-in-evaluation-of-trigeminal-neuralgia-with-its-anatomical-correlation","status":"publish","type":"post","link":"https:\/\/biomedpharmajournal.org\/staging\/vol12no1\/role-of-magnetic-resonance-imaging-in-evaluation-of-trigeminal-neuralgia-with-its-anatomical-correlation\/","title":{"rendered":"Role of Magnetic Resonance Imaging in Evaluation of Trigeminal Neuralgia with its Anatomical Correlation"},"content":{"rendered":"

Introduction<\/strong><\/p>\n

The International Association for the study of pain (IASP) defines pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. IASP in November 2010 further extended to define neuropathic pain as \u201cPain initiated or caused by primary lesion or dysfunction of the peripheral or central nervous system.1\u00a0<\/sup>This is a modification of the previous definition of neuropathic pain which was described as \u201cpain initiated or caused by a primary lesion, dysfunction, or transitory perturbation of the peripheral or central nervous system\u201d.2<\/sup>\u00a0When compared to nociceptive pain, the persistence of neuropathic pain is longer, not quite responsive to pain medications, often debilitating and difficult to treat.3<\/sup>\u00a0Neuropathic pain is frequent with other predisposing conditions like diabetes, carpal tunnel syndrome, sciatica, Guillain-Barre syndrome, cancer,\u00a0multiple sclerosis, kidney disorders, alcoholism, HIV etc. The prevalence and incidence of neuropathic pain is estimated between 1 and 10%, with few studies admitted that neuropathic component may be present in 35% of all painful syndromes.4<\/sup>\u00a0Smith BH and co-workers stated that the estimate of prevalence tends to be lower (1-2%) than those based on classic symptoms reports.5<\/sup>\u00a0Gustorff et al. from their prospective survey in 2008 showed that in Austria the occurrence of neuropathic pain was 3.3%, with an increase in prevalence (up to 26%) as the age increases.6<\/sup>\u00a0Van Hecke et al. believed that due to lack of universal evidences and protocols, a range of incidence and prevalence rates has been identified. They also suggested that future epidemiological studies should take note of mentioned factors.7<\/sup><\/p>\n

Trigeminal Neuralgia (TN)<\/strong><\/p>\n

Trigeminal neuralgia (Tic douloureax), is a chronic pain affecting the Trigeminal nerve.\u00a0 Burchiel KJ defined trigeminal neuropathic pain as constant unilateral facial pain that varies in intensity, is triggerable, and not curable.8<\/sup>\u00a0This is characterized by episodes of unilateral, lancinating, shock- like pains and are also intermixed with pain free episodes.<\/p>\n

Clinical Features for Trigeminal Neuralgia<\/strong><\/p>\n

International Headache Society had recently proposed strict clinical criteria for trigeminal neuralgia diagnosis and according to this, diagnosis only can be made when there are at least three attacks of unilateral facial pain occur fulfilling the following criteria such as (1) occurring in one or more divisions of the trigeminal nerve, with no radiation beyond the trigeminal distribution and (2) pain with at least, recurring in paroxysmal attacks lasting from a fraction of second to 2 minutes or severe intensity or electric shock-like, shooting, stabbing, or sharp in quality or precipitated by innocuous stimuli to the affected side of the face.9<\/sup>\u00a0Eller JL and co-workers, in their new classification differentiated TN into type 1 and type 2 which was earlier referred as classic or typical TN and secondary TN respectively. Type 1 is characterized by episodic pain whereas type expresses as pain which more than 50% of the time is constant in nature.10<\/sup>\u00a0It also has been theorized that in type 2, there is likelihood to detect a structural abnormality such as tumours or vascular malformations.<\/p>\n

Imaging Modalities in Evaluation of Trigeminal Neuragia<\/strong><\/p>\n

A wide variety of imaging modalities were used in past for image evaluation of the cranial nerves. Pneumocephalography was the first cross- sectional imaging study used to demonstrate cranial nerves. This technique involves introduction of air into subarachnoid space around cranial nerves in order to allow clear visualization of nerves within the basal cisterns.11<\/sup>\u00a0Later, with advent of CT, the detail in visualizing the regions of cranial nerves has improved and further with injection of intrathecal contrast shows linear filling defects within subarachnoid space. But the visualization is limited to the cisternal or subarachnoid course of cranial nerves. But with advent of MRI, an imaging modality without using ionizing radiation and acquisition of multiple plane images it became standard mode of imaging of cranial nerves.12<\/sup><\/p>\n

It is qui<\/p>\n","protected":false},"excerpt":{"rendered":"

Introduction The International Association for the study of pain (IASP) […]<\/p>\n","protected":false},"author":9,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[63],"tags":[],"class_list":["post-26086","post","type-post","status-publish","format-standard","hentry","category-vol12no1"],"_links":{"self":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/26086","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/comments?post=26086"}],"version-history":[{"count":7,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/26086\/revisions"}],"predecessor-version":[{"id":32348,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/26086\/revisions\/32348"}],"wp:attachment":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/media?parent=26086"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/categories?post=26086"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/tags?post=26086"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}