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Title: Little Help Post by KevinD on Feb 3rd, 2004, 4:29pm In all the readings I have done on CH, I have never heard this. Can somebody tell me what this means "My understanding of the pathophysiology of cluster is that the sympathetic sphenopalatine gangion becomes "activated", so I would favor a procedure that targets that rather than the trigeminal nerve which also carries normal sensory information. I do not know if such a procedure exists. |
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Title: Re: Little Help Post by CJohnson on Feb 3rd, 2004, 5:03pm Please list the source of this information. As I understand it, during an attack, the trigeminal nerve is irritated and starts doing a bunch of stuff, like sending pain signals to the part of your brain which interprets pain signals. Among the signals the trigeminal nerve is sending, are signals to the sphenopalatine ganglion which act as a positive feedback system to dilate the blood vessels (which are already dilated) further and irritate trigeminal endings. Once the loop is established it builds into a headache and lasts until whatever acts to terminate the "loop". A treatment which targets the sphenopalatine ganglion would prevent the "feedback loop" and an attack could not be sustained. I believe there is a procedure which targets the sphenopalatine ganglion called a sphenopalatine ganglion block, which has been used specifically for treatment of clusters. The trigeminal nerve, while sending pain signals, also carries touch signals, and temperature signals. The sphenopalatine ganglion does not relay those types of signals. The author doesn't want to stop his patients from feeling touch and temperature in their face to prevent them from feeling pain, if it can be helped. I assume. PFDANs -Curtis |
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Title: Re: Little Help Post by fubar on Feb 3rd, 2004, 5:14pm The trigeminal nerve is the largest cranial nerve and is the great sensory nerve of the head and face, and is also motor nerve of the muscles for chewing food. Some people have surgery on it to treat clusters, but they risk damaging the nerve (that's bad). Associated with the three divisions of the trigeminal nerve are four small ganglia. One of those is the sphenopalatine ganglion with the maxillary nerve; All four receive sensory filaments from the trigeminal. These filaments are called the roots of the ganglia. I guess this person has done some research and found reference to CH pain being related to 'activation' of that ganglion, so they wonder if an operation exists to maybe mess with that ganglion instead of the trigeminal nerve. -Shawn Curtis you beat me to it. |
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Title: Re: Little Help Post by Mark C on Feb 3rd, 2004, 8:48pm " This technique is carried out as follows: the patient is placed supine on the treatment table and the anterior aspect of the nasal turbinate of either nare is first anesthetized with 4% lidocaine aerosol spray. Five minutes later, with the patient remained in supine position and the nose pointed at the ceiling, an intratracheal cannula (Hakko Co. Tokyo, Japan) with preloaded 5 ml of 4% lidocaine is inserted into the nose passing along the upper border of the inferior turbinate and directed backwards until the upper posterior wall of the nasopharynx is reached. The patient is observed for 20 minutes with monitoring of vital signs, then discharged home." Link appears to be Chinese of all things. PFDAN's Mark |
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Title: Re: Little Help Post by t_h_b on Feb 3rd, 2004, 8:59pm I don't understand how the topical application of lidocaine to a ganglion can produce results that last a week. What am I overlooking here? |
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Title: Re: Little Help Post by KevinD on Feb 4th, 2004, 8:43am The source was my neuro. I guess I wasn't giving him enough credit. Too many big words for someone on a dopamax/lithium combo |
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