Diagnosis and management of traumatic neuropathy
- Authors: Tanashyan M.M.1, Maksimova M.Y.1, Fedin P.A.1, Lagoda O.V.1, Musaeva E.M.2
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Affiliations:
- Research Center of Neurology
- Peoples' Friendship University of Russia
- Issue: Vol 12, No 2 (2018)
- Pages: 22-26
- Section: Original articles
- Submitted: 09.08.2018
- Published: 09.08.2018
- URL: https://annaly-nevrologii.com/journal/pathID/article/view/524
- DOI: https://doi.org/10.18454/ACEN.2018.2.3
- ID: 524
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Full Text
Abstract
Introduction. Traumatic trigeminal neuropathy in neurological practice occurs relatively rarely.
Objectives. To study clinical and neurophysiological features of traumatic trigeminal neuropathy caused by orthognathic surgeries.
Materials and methods. Patients (n=24; aged 23–56 years) undergone orthognathic surgery, in short-term postoperative period (no more than 1 month since the surgery) received a therapeutic course of rhythmic magnetic stimulation. Stimulation pulse was 1–1.5 T, pulsing frequency 1 Hz, duration of the treatment 15–20 minutes daily, the course of treatment 10 days. Acoustic brainstem and trigeminal evoked potentials were recorded.
Results. The clinical picture of post-operative trigeminal neuropathy is dominated by hypoesthesia of varying severity, and the trigger zone of the face and in the mouth are not determined. Tenderness of trigeminal nerve exit point was observed in 2nd, 3rd as well as in all three branches of the trigeminal nerve. In the study of acoustic brainstem evoked potentials there were identified changes at the medulla-pontine level more evident on one side (usually on the right), shortening of the latent periods of three peaks, I–III–V peaks amplitudes increase on both sides, and confluence of II–III peaks, mostly on one side. Reduction of latency and increase of amplitude of trigeminal evoked potentials components indicate dysfunction of the trigeminal system on both sides. Clinical effect expressed in improvement of sensitive disturbanses after the course of rhythmic magnetic stimulation was observed in 83% of patients; at the same time there was observed some delay of improvement of neurophysiological symptoms.
Conclusion. Clinical-neurophysiological dissociation after the course of rhythmic magnetic stimulation can be explained by the short term of the course, incomplete recovery of functions of the structures involved in the stimuli conduction, as well as by the lack of adequate medical support.
About the authors
Marine M. Tanashyan
Research Center of Neurology
Email: ncnmaximova@mail.ru
ORCID iD: 0000-0002-5883-8119
D. Sci. (Med.), Prof., Corresponding member of RAS, Deputy Director for science, Head, 1st Neurological department
Russian Federation, MoscowMarina Yu. Maksimova
Research Center of Neurology
Author for correspondence.
Email: ncnmaximova@mail.ru
ORCID iD: 0000-0002-7682-6672
D. Sci. (Med), Prof., Head, 2nd Neurology department; professor, Division of diseases of the nervous system, Department of dentistry
Russian Federation, 125367 Moscow, Volokolamskoye shosse, 80; MoscowPavel A. Fedin
Research Center of Neurology
Email: ncnmaximova@mail.ru
Russian Federation, Moscow
Olga V. Lagoda
Research Center of Neurology
Email: ncnmaximova@mail.ru
Russian Federation, Moscow
Elvira M. Musaeva
Peoples' Friendship University of Russia
Email: ncnmaximova@mail.ru
Russian Federation, Moscow
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