{"title":"LOCAL ANESTHETIC SPREAD TO THE CONTRALATERAL TRIGEMINAL GANGLION","authors":"Kim T. Nguyen","doi":"10.36076/pmcr.2019/3/59","DOIUrl":null,"url":null,"abstract":"Chronic neuropathic pain syndromes can severely\naffect a person’s quality of life. Trigeminal\nneuralgia is among these syndromes and involves\nthe mandibular branch of the fifth cranial\ntrigeminal nerve. Patients typically present with\nfacial pain described as electrical and shock-like\nin nature, exacerbated by movements of the jaw\nsuch as talking and chewing. Many patients are\nunable to achieve adequate relief with medical\nmanagement and therefore require interventions\nsuch as injections of local anesthetics, steroids,\nor glycerol. One method of injection uses ultrasound\nguidance for local anesthetic injection in\nthe pterygopalatine fossa affecting the trigeminal\nganglion.\nA 64-year-old woman with a history of trigeminal\nneuralgia presented for a trigeminal nerve block on\nher right side via ultrasound guidance. Following\nthe injection, she experienced the desired effect\nof numbness on her right side in the distribution\nof the trigeminal nerve. In addition, the patient\nreported feeling the same effects on her left side\ndespite no injection being done on that side.\nWe describe a unique case in which local anesthetics\nspread through the pterygopalatine fossa\nand across the midline, affecting the contralateral\ntrigeminal ganglion. Patients should be monitored\nfor hemodynamic changes following this injection.\nKey words: Trigeminal neuralgia, trigeminal\nnerve block, pterygopalatine fossa, regional block,\ntrigeminal ganglion","PeriodicalId":110696,"journal":{"name":"Pain Management Case Reports","volume":"24 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain Management Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36076/pmcr.2019/3/59","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Chronic neuropathic pain syndromes can severely
affect a person’s quality of life. Trigeminal
neuralgia is among these syndromes and involves
the mandibular branch of the fifth cranial
trigeminal nerve. Patients typically present with
facial pain described as electrical and shock-like
in nature, exacerbated by movements of the jaw
such as talking and chewing. Many patients are
unable to achieve adequate relief with medical
management and therefore require interventions
such as injections of local anesthetics, steroids,
or glycerol. One method of injection uses ultrasound
guidance for local anesthetic injection in
the pterygopalatine fossa affecting the trigeminal
ganglion.
A 64-year-old woman with a history of trigeminal
neuralgia presented for a trigeminal nerve block on
her right side via ultrasound guidance. Following
the injection, she experienced the desired effect
of numbness on her right side in the distribution
of the trigeminal nerve. In addition, the patient
reported feeling the same effects on her left side
despite no injection being done on that side.
We describe a unique case in which local anesthetics
spread through the pterygopalatine fossa
and across the midline, affecting the contralateral
trigeminal ganglion. Patients should be monitored
for hemodynamic changes following this injection.
Key words: Trigeminal neuralgia, trigeminal
nerve block, pterygopalatine fossa, regional block,
trigeminal ganglion