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DECOMPRESSION OF THE SENSORY ROOT AND ITS REACTION TO TRIGEMINAL NEURALGIA DISCUSSION OF THE CAUSE OF TRIGEMINAL NEURALGIA

A total of 100 patients with tic douloureux were followed up following surgery in two series; in one, the extradural approach was used and the trigeminus sensory root was manipulated in its dural sleeve, while in the other, the trigeminus sensory root was manipulated in the dura. The intradural approach, which caused less postoperative sensory impairment in 100 patients, injured the semilunar ganglion less, and caused more complete relief in 62% of the cases. The patients, however, experienced mild recurrences in 11.5% and severe recurrences in 26.5% of the cases.

A degree of sensory loss had been reported in 26% of those with successful treatment, as well as in 28.3% of those with ineffective treatment. Neither surgical trauma to the nerve root nor incision of the nerve root’s dural sleeve was necessary to ensure success. Neurolysis or manipulation of the sensory root at the point where it crosses the apex of the pars petrosa of the temporal bone appeared to be the key part of the operation.

Many experts believe the cause of this condition is segmental demyelination of the trigeminal sensory nerve in the nerve root or brain stem, accompanied by chronic compression of the nerve root.

Multiple sclerosis is also a link. The incidence of multiple sclerosis is approximately 4 per 100,000 of the population, and only gets worse with age. The average age of onset is 60, with few diagnosed before age 40.

Clinical hygienists at chairside treating patients with TN need to understand more about this, as the triggers can have a profound impact on treatment. It has been described as an electric lightning bolt of intense pain to yawn, speak, chew, brush one’s teeth, and simply touch one’s face. Imagine the extraoral fulcrum you might use during instrumentation. Even the lightest feather-like finger rest could prove disastrous to TN patients. The painful sensation is usually unilateral, lasts several seconds to several minutes, and can occur a few times a day or hundreds of times a day.

Remission can occur, but the intervals between relapses tend to shorten as the patient ages. TN is diagnosed based only on history, after hearing the patient’s description of the pain. It is believed that the condition can lead to depression since daily life activities can be impaired. Experts find that symptoms worsen over time and become less responsive to medication, despite dosage increases and other agents being added.

When it comes to treatment success for TN, standard definitions vary depending on whether it is medical or surgical. If at least half of pain relief compared to baseline readings is achieved with medication, it is considered successful. However, with surgical studies, measurements are different. Complete pain relief is the goal, so this would be considered treatment success.

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Health

Your brain and body will thank you for catching a few Zzzzzs.

Kayleigh DeMace

Sleep is a fundamental part of life. And while scientists are still not entirely sure what it does, we do know it impacts our performance throughout the day. Find ways to prioritize resting at night so you’re recharged for the next day.

It benefits you in so many ways to get enough sleep:

Boost your brainpower

Rest helps your brain function at its best. This will improve your productivity, your ability to concentrate, and your emotional intelligence. If you get good sleep, you’ll be more empathetic. You won’t yawn when your friend is upset about a breakup. And you’ll find the right words to encourage an overworked colleague.

Bonus: Getting enough sleep has the added perks of sharpening your memory and problem-solving skills, no matter your age.

You need to revitalize your body

If you’re hitting the gym, sleeping well can improve your workout. “When you sleep well, your muscles are able to fully rest and recover so you won’t drag your feet at the gym,” says Dr. Boris Gilyadov, sleep medicine specialist and family physician.

You’ll be less likely to develop heart disease, heart attack, stroke, depression, and inflammation with enough sleep. Plus, your immune system will be functioning at its best, so you’ll be able to resist viruses and bacteria.

Lack of sleep causes what effects?

It’s not just children who suffer from sleep deprivation – it’s both adults and children. Stress, anxiety, narcolepsy, and sleep apnea can all contribute to sleep deprivation. Other effects of poor sleep? Obesity, an increased sense of pain and a weaker response to vaccines.

Chronic sleep deprivation may also increase your risk of cognitive decline and dementia.

Sleep deprivation and poor sleep quality can have a direct impact on performance and behavior at school in children,” says Dr. Gilyadov. “Poor sleep quality includes frequent nighttime awakenings.”

What can you do to sleep better?

Set a routine: Get up and go to bed at the same time every day. Even on weekends.

Wake up, and get moving. Summertime is great for getting a better night’s sleep, according to Dr. Gilyadov. Being outside and exercising reduce stress, which directly impacts your rest.

Don’t sleep too much. If you’ve had enough sleep, don’t sleep more — because oversleeping isn’t good for you, either. It can raise your risk for diabetes, heart disease and stroke. Stick to that sleep schedule mentioned above.

Turn off your phone. Put the phone away at least an hour before bed. Exposure to blue light can shorten your slumber.

Having trouble sleeping? Talk to your doctor. They’ll help you find the right treatment to help you sleep better.

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Health

Fitness Trends Over 50 You Should Follow

Fitness trends deserve a little skepticism.

Besides, it’s easy to find companies that promise miracle results by showing super-fit people using their product for minutes a day. Just because something gets attention doesn’t mean it works.

Yet that doesn’t mean you should exercise the same way you did 30 years ago.

With the science of exercise having advanced over the decades, people over 50 will achieve better results and have a more enjoyable exercise experience by utilizing some of the newer trends in fitness.

1. Wearables can help you monitor your health and fitness

If you look at any list of fitness trends, wearables will likely be at the top. For those unfamiliar with the term, wearables refer to any device that tracks your activities, such as a smartwatch, Fitbit tracker, heart-rate monitors and others.

Fitness tracking devices are expected to grow much more rapidly than other health-related devices.The ability to monitor your sleep and heart rate is already available on many devices, but some are predicting that it’s just the start, with blood pressure and illness tracking to follow in the years to come.

Nowadays, the technology is quite impressive, and it can make a huge difference in maintaining your fitness regime. Being able to track your workouts accurately can be motivating, and the costs have decreased significantly.Wearables can provide all kinds of valuable data as well as online coaching and other resources to help you create an exercise plan for less than $100.

2. GET OUTSIDE

Due to the limited options indoors in 2020, it is not surprising that people spent more time exercising outdoors. However, it turns out many people actually liked the change.

According to one study, almost 40 percent of people surveyed planned to give up gym memberships and focus on exercising at home or outdoors instead.Many people decided to leave the gym because they realized there are a number of resources nearby such as bike trails, sports courts, and hiking trails.

If you’re exercising with a group, outdoor exercise provides a social outlet as well as a way of getting exercise outside rather than on a treadmill or stationary bike.Running groups and tennis clubs provide you with the chance to meet like-minded individuals and motivate you to work out.You don’t have to choose between indoor or outdoor workouts: You can mix them up as you please.

3. HIRE SOME HELP

As the year comes to a close, many people are looking for help getting back on track. Since 2020 has been a year with a more sedentary vibe, people are seeking the help of experts.There has been an increase in demand for personal trainers and nutritionists in recent years. Even if you are already exercising, a trainer can help set specific goals, recommend training plans, and motivate you.

4. INCREASE YOUR FLEXIBILITY

It’s hard not to notice an increasing number of classes focusing on flexibility, such as yoga, Pilates, and Tai Chi.As we age, we lose flexibility as well. Thankfully, like with muscle loss, you can slow the loss.Running and cycling are examples of repetitive exercises that may lead to overuse injuries. A flexible body can help prevent these injuries.

Beginner classes are welcoming to everyone, and you can make a big difference even if many of the moves seem impossible.

If you exercise at home, you may want to invest in inexpensive resistance bands, as they can help you increase your mobility and engage muscles that are otherwise inactive.

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BLOG&NEWS

Harvest of Supraspinal Nerve Grafts

Anatomy of the Sural Nerve
The sural nerve consists of two parts: a medial sural cuteus nerve and lateral sural cuteus nerve.

This nerve arises from the tibial nerve just below the knee joint and runs downward between the gastronemius heads.

Located on the posterolateral side of the calf, the lateral sural cutaneous nerve arises from the common peroneal nerve.

A sensory cutaneus nerve (also known as short saphenous nerve), except for some unmyelinated autonomic fibers, emerges from the root of the S1 or S2 nerve.With a relatively easy technique, up to 25 cm of nerve graft can be harvested. The sural nerve innervates the lateral third of the leg, the side of the foot, the heel, and the side of the ankle. Sural nerve grafts are frequently used as cable grafts.

Indications

The graft is accessible to the distal and proximal segments of an intact motor or sensory nerve.

Contraindications

Peripheral neuropathy with compromised sensation to the lower extremity may also create a contraindication if the patient requires intact foot and lower leg sensation (for employment or sports reasons).

Graft Harvesting Technique

It is best to identify the sural nerve approximately 2 cm posterior to the lateral malleolus and approximately 2 to 3 cm proximal. In this area, it has not undergone significant branching.It is necessary to make a longitudinal incision in the region above, and if the saphenous vein is visible, the nerve or a branch of it is close by. The nerve can be traced proximally through this incision or through a series of “stairstep” transverse incisions.

After exposing the nerve proximally and distally, the nerve is cut proximally and distally and placed on moist gauze. The proximal incisions are determined by gently pulling the nerve at the distal incision.Sutures of 4-0 Vicryl are used to close the donor site, and staples or nylons are used to close the skin.

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Health

Does energy drink have any health benefits?

Energy Drinks – what are they?

They are marketed to increase energy, weight loss, stamina, athletic performance, promote wakefulness, and enhance weight loss. Energy drinks contain caffeine, taurine, vitamins, and herbal supplements in addition to sugar or sweeteners.

Although they may seem like a new fad, these drinks have been available to the public for some time. For instance, Red Bull (currently one of the most popular energy drinks) was introduced in Austria in 1987 and to the United States in 1997.The original coca leaf (from which cocaine is derived) and kola nut (from which caffeine is derived) form of cola soft drinks was available in 1886, with similar results to energy drinks at the time.

There are many energy drinks that are packed full of caffeine, taurine, l-carnitine, carbohydrates, glucuronolactone, vitamins, and herbal supplements, such as ginseng and guarana.

It is not required that manufacturers of energy drinks include the caffeine content of herbal supplements such as guarana, yerba mate, cocoa, and kola nuts in the nutritional information, so consumers are unaware of this aspect.There are different brands of energy drinks that contain caffeine ranging from 50mg to 550mg per can or bottle

In high doses, caffeine may cause abnormal stimulation of the nervous system, and is one of the most commonly consumed alkaloids worldwide in the form of coffee, tea, and soft drinks.

Energy drinks contain caffeine, which can have adverse effects on the cardiovascular, hematological, and gastrointestinal systems. Many contain 70 to 80 mg of caffeine per 8-ounce serving (*3 times more than in cola drinks).It is possible for the caffeine content of 16-ounce drinks to be nearly five times that of 8 oz of cola drinks when packaged as “energy shots” (0.8-3 oz) or as 16-oz drinks

There are now 11 percent of energy drinks sold in the U.S. that are energy shots, a type of energy drink. Energy shots are the fastest-growing segment of the energy drink market.Most energy drinks come in 12 and 16 ounce (355 and 474 ml) cans or bottles, whereas energy shots come in smaller 50 ml bottles. Both energy drinks and energy shots contain the same amount of caffeine, however, energy shots tend to contain more sugar.

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BLOG&NEWS

Tic douloureux

Trigeminal neuralgia, also known as tic douloureux, is a chronic pain condition that causes burning or shock-like pain in the face. Nicolaus Andre, a French physician, coined the term “tic douloureux” in 1756 in reference to the facial spasms that can occur during severe pain attacks.

The pain that occurs in short, unpredictable episodes rarely lasts more than a few seconds or a minute or two in a trigeminal neuralgia attack. The pain can feel like an electric shock or can be described as a sharp shooting pain.

Generally, trigeminal neuralgia affects just one side of the face. The pain is felt on the lower part of the face. Trigeminal neuralgia can progress to cause longer, more frequent attacks of searing pain.

The pain can sometimes affect both sides of the face, though not always at the same time.

The intensity of pain can be physically and psychologically incapacitating. People with tic douloureux may have regular attacks for days, weeks or months at a time. In severe cases attacks may happen hundreds of times a day.

Even though it can be debilitating, this disorder does not pose a life-threatening threat. A spontaneous remission is possible, although most people experience episodes over a long period of time.

The anatomy of the trigeminal nerve

This nerve supplies the face with sensory information and provides motor and sensory input to the masticatory muscles. It is a fifth cranial nerve (CN V).

Three trigeminal nerves split off from the trigeminal nerve (trigeminal = threefold):

  1. Ophthalmic (V1): Supplies the eye, upper eyelid, and the forehead
  2. Maxillary (V2): Supplies lower eyelid, cheek, nostril, upper lip, and upper gum
  3. Mandibular (V3): Supplies the lower lip, lower gum, jaw and the muscles of mastication

The mandibular division of the trigeminal nerve provides somatic motor innervation for the chewing muscles. The trigeminal nerve is a mixed nerve and it supplies the general somatic sensory function for touch, temperature, and pain in the face.

This figure shows the fifth cranial nerve, the trigeminal nerve.

Tic douloureux causes

Trigeminal neuralgia, also known as tic douloureux, occurs when the trigeminal nerve’s function is disrupted. Most cases result from compression of the trigeminal nerve root near its entry point into the pons.The problem is usually caused by a contact between a blood vessel – in this case, an artery or a vein – and the trigeminal nerve at the base of your brain. This pressure puts pressure on the nerve, causing it to malfunction.

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