Second Division Of Trigeminal Nerve Research Articles

Nevus of Ota with palatal involvement: a case report

Nevus of Ota is a macular discoloration of the face which is most commonly found in the Japanese and females are more commonly affected than males. It is first described by Ota and Tanino in 1939, involves the skin along the distribution of first and second division of trigeminal nerve. Involvement of the palatal mucosa occurs rarely in nevus of Ota, it usually blends with the oral mucosa and is typically irregular, undefined and often present as a mottled patch. We describe here the case of nevus of Ota with palatal involvement in a 13-year-old Asiatic boy. His past medical history revealed the presence of the lesion since birth. There were no other pigmented lesion locations. The exact etiology of nevus of Ota is still unknown but they have the potential to undergo melanomatous change.

Herpes Zoster Infection of Maxillary Nerve in a Healthy Lady

Herpes zoster infection (HZI) occurs as a result from previous exposure to varicella zoster virus and the disease recurred at later onset of life when patient are in immunocompromised state. The manifestation can be varies and in fact can involve all parts of dermatome distribution. We present a case of HZI involving the second division of trigeminal nerve which involved danger triangle of face that resolved after one week of intravenous acyclovir.International Journal of Human and Health Sciences Vol. 02 No. 02 April’18. Page : 94-97

Nevus of Ota: Effective Treatment by Laser

The nevus of Ota is a dermal nevus characterized by bluish pigmentation in the distribution of the first and second division of trigeminal nerve. A total of ten cases were included in our study, detailed history and complete clinical examination were done for all patients. Most of the patients had lesions at birth and the majority was females. The treatment was done by Q-Switched Nd:YAG laser 1,064 nm and fractional 2940nm Er:YAG laser. 34% show excellent results, 53% show good results, while 13% show poor results. Objective : The aim of this study is to explore the long lasting results of Q-Switched laser in association with fractional laser for treatment of nevus of ota.

Painful ophthalmoplegia due to Tolosa-Hunt syndrome: a case report

Tolosa-Hunt syndrome (THS) is a rare clinical entity, characterized by sudden onset of painful ophthalmoplegia and prompt response to steroid therapy. Generally, it involves the third, fourth, and sixth cranial nerves due to presence of non-specific inflammation at the level of cavernous sinus or superior orbital fissure. In some cases, first or second division of trigeminal nerve may also be involved. Here we present a case report on THS, a rare cause of painful ophthalmoplegia. The patient presented with sudden onset, unilateral headache, drooping of left upper eyelid followed by diplopia. On examination, the patient had complete ophthalmoplegia, along with ophthalalmic division of trigeminal nerve was also involved. Magnetic resonance imaging (MRI) brain showed expansion of left cavernous sinus suggesting THS. Other differentials of THS were ruled out on the basis of careful history, examination, and investigations.

Mastoiditis and Gradenigo’s Syndrome with anaerobic bacteria

BackgroundGradenigo’s syndrome is a rare disease, which is characterized by the triad of the following conditions: suppurative otitis media, pain in the distribution of the first and the second division of trigeminal nerve, and abducens nerve palsy. The full triad may often not be present, but can develop if the condition is not treated correctly.Case presentationWe report a case of a 3-year-old girl, who presented with fever and left-sided acute otitis media. She developed acute mastoiditis, which was initially treated by intravenous antibiotics, ventilation tube insertion and cortical mastoidectomy. After 6 days the clinical picture was complicated by development of left-sided abducens palsy. MRI-scanning showed osteomyelitis within the petro-mastoid complex, and a hyper intense signal of the adjacent meninges. Microbiological investigations showed Staphylococcus aureus and Fusobacterium necrophorum. She was treated successfully with intravenous broad-spectrum antibiotic therapy with anaerobic coverage. After 8 weeks of follow-up there was no sign of recurrent infection or abducens palsy.ConclusionGradenigo’s syndrome is a rare, but life-threatening complication to middle ear infection. It is most commonly caused by aerobic microorganisms, but anaerobic microorganisms may also be found why anaerobic coverage should be considered when determining the antibiotic treatment.

Gradenigo's syndrome with lateral venous sinus thrombosis: successful conservative treatment

Gradenigo's syndrome (GS) is a rare disease characterised by the triad otitis media, pain in the region innervated by the first and the second division of trigeminal nerve and abducens nerve palsy. Septic sinus thrombosis is one of the most frequent and relevant complication of GS; it is often due to persistent damage and late diagnosis. Computed tomography (CT) scan and magnetic resonance imaging (MRI) allow the correct diagnosis in most cases. Surgical therapy may be necessary for a better and more rapid resolution of the disease. We report the case of a 4-year-old child that was admitted for facial nerve palsy and abducens nerve palsy subsequent to a 2-week persistent pain in the right ear. MRI showed infective acute process of the right mastoid and partial ipsilateral sinus thrombophlebitis. The child was treated with high-dose intravenous antibiotics and with oral anticoagulants. A complete resolution of symptoms and radiological alterations were observed within 7 weeks. In conclusion, lateral sinus thrombosis and Gradenigo's syndrome are rare but potential fatal complications of otitis media and mastoiditis. High-dose intravenous antibiotics and a low dose of anticoagulant can achieve a complete recovery without surgery.

Paroxysmal hemicrania: a prospective clinical study of 31 cases

Paroxysmal hemicrania is a rare syndrome characterized by repeated attacks of strictly unilateral, severe, short-lasting pain occurring with cranial autonomic features. The hallmarks of this syndrome are the relatively short attacks and the exquisite response to indometacin. We describe the phenotype of this condition in a series of 31 patients. The mean duration of attack was 17 min. The mean attack frequency was 11. The distribution of the pain was orbital and temporal in 77% of the patients, retro-orbital in 61%, frontal in 55%, occipital in 42%; although pain was also reported in the vertex, second division of trigeminal nerve, neck, nose, jaw, parietal region, ear, teeth, eyebrow, shoulder (ipsilateral and bilateral), arm and third division of trigeminal nerve. Of the cohort, 87% had lacrimation, 68% had conjunctival injection, 58% rhinorrhoea, 54% nasal congestion, ptosis and facial flushing. Other cranial autonomic features include eyelid oedema, forehead/facial sweating, sense of aural fullness and periaural swelling, miosis, mydriasis and swelling of the cheek. The majority of the patients (80%) were agitated or restless, or both, with the pain and 26% were aggressive. All patients had positive placebo control indometacin test (100-200 mg intramuscularly), or a positive oral indometacin trial or both. We suggest the International Headache Society criteria be revised to remove specification of attack site, and to include the full range of cranial autonomic features. Currently, the sine qua non for paroxysmal hemicrania is a response to indometacin. Since there is no reliable clinical marker of that response we recommend an indometacin test, either orally or by injection for any patient with lateralized discrete attacks of head pain with associated cranial autonomic symptoms.

Acute onset of abducens nerve palsy in a child with prior history of otitis media: a misleading sign of Gradenigo syndrome

Gradenigo syndrome in children during otitis media is a very rare complication since the use of antibiotics: nevertheless, it must be taken into account in case of otitis media, abducens nerve paralysis and facial pain in regions innervated by the first and second division of trigeminal nerve. We report the case of a 4-year-old boy whose neurological signs and clinical history prompted us to entertain a diagnosis of Gradenigo syndrome, which was not confirmed by CT and MRI findings, revealing otomastoiditis and sinus thrombosis.

Conservative management of Gradenigo syndrome in a child

Gradenigo syndrome consists of the association of otitis media, facial pain in regions innervated by the first and second division of trigeminal nerve and abducens nerve paralysis. It is caused by osteitis of the petrous apex (PA) and is a very rare complication of otitis media. Its treatment usually consists in mastoidectomy and antibiotics. We report a case of a 6-year-old child, which was managed medically with a positive outcome.