Citation:
Pandit M. Neurovascular Compression Syndromes: An Innovative Cure for Pain-Free Future. SunText Rev Neurosci Psychol 1(3):
116.
1
SunText Review of Neuroscience & Psychology Open Access
ISSN: 2766-4503 Editorial Article
Volume 1:3
Neurovascular Compression Syndromes: An
Innovative Cure for Pain-Free Future
Mayukh Pandit*
Department of Anatomy, Triveni Institute of Dental Sciences Hospital & Research Centre,
Bilaspur, Chhattisgarh 495001, India
*Corresponding author: Pandit M, Department of Anatomy, Triveni Institute of Dental Sciences
Hospital & Research Centre, Bilaspur, Chhattisgarh 495001, India; E-mail: mayukhpandit17 [at]
gmail [dot] com
Editorial Article
The word neuro comes from ancient greek, a combining form
meaning nerves and nervous system which builds the compound
word: neurology [1]. Nerve could be defined in simple terms as
whitish fibers or bundle of fibers that forms a part of the system
which transmit impulses of sensation, motion and other stimuli to
brain and spinal cord and impulses from these to muscles and
organs. Our brain is the most complex organ of our body and this
complexity of relying information between brain and different
parts of body primarily to and from regions of head and neck
including sense of vision, taste, smell and hearing which is
directed from brain by Cranial nerves. Sometimes compression in
these cranial nerves could lead to develop serious chronic
vascular compression disorder due to vascular structure.
Compression in nerves could lead to demyelination which leads
to further damage of axons. So, neurovascular compression
syndromes are vascular compression disorder where cranial
nerves are compressed due to abberant vascular structures which
directly contact the cisternal portion of nucleus. Neurovascular
compression syndromes most commonly affects the transition
zone between the central and peripheral myelin [2].
There are several forms of neurovascular compression syndromes
known out of which the most common ones are Trigeminal
neuralgia and Hemifacial spasm wheras Geniculate neuralgia,
Nervous intermedius neuralgia and Vestibular Paroxysmia are the
less common ones. All this forms of Neurovascular compression
syndromes are chracterised by functional disturbances of cranial
nerves.
Trigeminal Neuralgia
Trigeminal neuralgia is among the most common Neurovascular
compression syndromes known characterized by sudden
paroxysmal attack of pain lasting from few hours to several days
and confined to distribution of one or more divisions of
trigeminal nerve. International Headache Society defines
Trigeminal neuralgia as painful unilateral affliction of face
characterized by brief electric shock limited to divisions of
trigeminal nerve [3].
This chronic disorder affects more in women than in men.
Trigeminal neuralgia usually arises from blood vessles typically
Superior Cerebellar arterty which compress the 5th cranial nerve
when it exits the brain stem. This compression causes damage to
protective covering present around the myelin sheath. This injury
to myelin sheath are known to cause suffering of pain which
becomes unbearable and patients develops psychiatric disorders
which is followed by development of suicide ideation in patients.
Hence it is also called Suicide disease because it is believed more
than 50% of people commits suicide who are suffering from this
disorder.
Hemifacial Spasm
Hemifacial Spasm also known by the name as Tic Convulsif
which are characterized by irregular and involuntary contraction
of facial muscle [4].
Hemifacial spasm usually arises due to offendation of facial nerve
by Anterior Inferior cerebellar artery, due to tumor or injury. It
was first demonstrated and described by Glovers in 1899. This
begins with clonic movement of orbiculis oculi and spreads to
corrugators, frontalis, orbiculi oris, platysma and zygomaticus
Received date: 19 October 2020; Accepted date: 26
October 2020; Published date: 29 October 2020
Citation: Pandit M. Neurovascular Compression
Syndromes: An Innovative Cure for Pain-Free Future.
SunText Rev Neurosci Psychol 1(3): 116.
DOI: https://doi.org/10.51737/2766-4503.2020.016
Copyright: © 2020 Pandit M. This is an open-access
article distributed under the terms of the Creative
Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are
credited.
Pandit
, SunText Rev Neurosci Psychol (2020), 1:3
Citation:
Pandit M. Neurovascular Compression Syndromes: An Innovative Cure for Pain-Free Future. SunText Rev Neurosci Psychol 1(3):
116.
progressively with years [5]. This disorder affects more in elderly
women wheras frequency is less in men. The incidence of
Hemifacial spasm is approx 0.8per 100,000 persons [6]. This
form of neurovascular compression syndromes are usually
observed more in the subcontinent of Asian countires.
Glossopharyngeal Neuralgia
Glossopharyngeal neuralgia also known by the name as Eagle’s
syndromes characterized by brief stabbing electric shock like pain
felt in throat area , back of tongue, or middle ear and as well as in
tonsils. This neuralgia is among the most rare and less common
ones. Glosspharyngeal neuralgia arises due to compression of
glosspharyngeal nerve offended by blood vessels when they exit
the brain stem. This occurs due to trauma, surgical procedure,
tumors, and vascular abnormalities or sometimes due to infections
as well. This disorder also affects more in women than men,
usually middle aged and older. The pain due to this syndrome
would be triggered while performing activities like swallowing,
speaking, laughing, chewing or coughing [7]. The duration of this
pain would lasts from few seconds to minutes and will usually
affect on one side of face.
Nervous Intermedius Neuralgia
Nervous Intermedius neuralgia also known by the name as
Geniculate neuralgia. This usually arises from vascular
compression which mainly occurs in nervous intermedius by
anterior inferior cerebellar artery. Nervous Intermedius neuralgia
was first discovered and demonstrated by John Nottingham. This
is one of the most less common syndromes which occurs with
severe and sharp unilateral peri-auricular pain and is most often
described as ‘ice-prick in the ear’ [8]. The International Headache
Society defines this neuralgia as episodes of pain usually located
deep in the ear which might last for seconds or minutes and are
often triggered by sensory or mechanical stimuli at posterior wall
of auditory canal without any pathology.
Vestibular Paroxysmia
Vestibular Paroxysmia is among the rarest of neurovascular
compression syndromes which occurs due to vascular
compression of vestibular nerve by blood vessels mainly a loop of
Anterior Inferior cerebellar artery. This disorder was first
described by Janetta in 1975 as ‘disabling positional vertigo’. The
symptoms of vestibular paroxysmia includes short attack of
spinning or non-spinning vertigo, which would usually last few
seconds to minutes and occur in a series of upto 30 or more
everyday [9]. Vestibular Paroxysmia is one the most controversial
syndromes known.
Treatments
The treatment of neurovascular compression syndromes starts
with therapeutic medications at initial stage of this disorder and
once it advances requires surgical procedures for permanent cure.
Medications which are used to treat almost all forms of
neurovascular compression syndromes and are found to be very
effective in controlling the pain and providing relief initially
includes [10]:
Carbamazepine
Baclofen
Phenytoin
Gabapentin
Clonazepam
Carbamazepine is considered as the drug of choice because it
provides very good relief of symptoms initially. But adverse
effects such as hyponatremia are usually observed which may
necessitate the discontinuation of medication. Also this
medication provides relief of symptoms for very short period of
time. So, the affected patient would require operative procedures
for long term pain relief.
There are various major and minor surgical procedure known
which are employed to cure Neurovascular compression
syndromes for long term basis of pain relief. Among all the
surgical procedure known , Microvascular decompression surgery
[MVD] have shown the highest pain relief period of 12-15 years
or more. In 1967, Dr Peter Janetta have introduced this surgical
procedure and reported his study in ‘The New England Journal of
Medicine’ . It showed that initial success rate was 82% for
complete pain relief [11]. The main objective of MVD was to
separate the offending nerve from vascular structure by placement
of Teflon sponge. Teflon sponge isolates the nerve from pulsating
effect and pressure of blood vessels. There are very serious
complications of MVD widely reported for Trigeminal neuralgia
and Hemifacial spasm such as intracerebellar hematoma with
acute hydrocepahalus, status epilepticus , subarchnoid
hemorrhage and also possible infections of brain stem [12]. Also
Teflon could be one of the major causes of recurrence which have
been reported to cause a condition known as Teflon Granuloma
after 5-10 years of operation. Teflon Granuloma both clinically
and pathologically could emulate malignancy. There are also
some adverse reactions observed from Teflon such as frontalis
muscle suspension in TMJ surgery as well as pericardial closure
in rheumatic heart surgery [13].
So for proper cure of Neurovascular compression syndromes one
must aim at repositioning of affected cranial nerve with better
alternative which will not produce any adverse effects and would
cure permanently. Working hard on this specific disorder for
years observing and specifically working in innovation of better
alternative which would cure all forms of neurovascular
compression syndromes without any adverse outcomes and with
Pandit
, SunText Rev Neurosci Psychol (2020), 1:3
Citation:
Pandit M. Neurovascular Compression Syndromes: An Innovative Cure for Pain-Free Future. SunText Rev Neurosci Psychol 1(3):
116.
null complications. I designed and invented a surgical implant
named as ‘MOLUMA’S’ Surgical Implant which would be able
to cure this disorder on permanent basis with very minimal
complications. This invention is named after my beloved parents
Moloy and Uma whom I want to express my heartiest gratitude
by curing and saving lives of sufferings. MOLUMA’S Surgical
Implant would be ensuring proper separation of offending
structures and will resist all forms of displacement along with
protecting the surrounding anatomical structures. MOLUMA’S
surgical procedure is designed on the bias of robotics which
would be able to resolve all complications and would produce the
best result in terms of permanent pain relief. I believe healthcare
facilities should be made accessible and affordable to every life
residing in perspective of cost. I am working; innovating,
improving and improvising more so that MOLUMA’S Surgical
Procedure would be cost-effective approach so that everyone
would be get treated from these severe painful disorders
efficiently and on permanent basis without any form of major
complications and recurrence.
Apart from cure of Neurovascular compression syndromes, I am
working in other fields of incurable disease and innovating their
cure on permanent basis with minimal complications and more
importantly making it very low cost effective ones, so that we
could proceed to an era of ‘disease-free’ world with no sufferings
from pain and where each and every one of us can get cured
permanently and lead rest our lives prosperously.
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