Trigexual pain induces sinus arrest in 1 case.

Trident nerve pain is a common neuropathy of the brain, mainly refers to the recurrent severe pain in the trident nerve distribution area, which manifests it in many ways and is often difficult to distinguish from other painful diseases.
April-May 2018, neurosurgery at Hebei University Hospital treated 1 case of trigexual nerve pain-induced sinus arrest using perforated micro-balloon compression (PBC), as reported below.
, 62, was admitted to hospital after more than two years with intermittent facial pain in her right face.
2 years ago, the patient developed pain in the upper and lower parts of the right side, which was needle-like and seizure-like;
to the hospital to see a neurology department, check no neurological positive signs.
diagnosis: neurological headache.
blood routine, electrolyte, liver and kidney function, etc. were not abnormal.
mri shows that the left vertebral artery end is extended and the left side of the myelin is pressurized.
electrostectric monitoring tips: heart arrest is visible when pain strikes.
24h dynamic electroctogram return: sinus heart rhythm is not the same, room early fight, pair of room early, short burst room speed, junction escape, room escape, once room conduction block, sinus stop, there are 52 times greater than 2.0s stop, the longest about 15.76s.
cardiology consultation recommends pacemaker implants.
neurosurgery consultation: except for central cardiac arrest, trigemical nerve pain, recommended surgical treatment.
pacemaker implants in the hospital, within 4 months after the operation, the patient regular oral gaba spray, the pain slightly alleviated, for further treatment back to the hospital.
: Induces pain when touching the outer arm of the right eye.
electrostartic monitoring shows that the heart rate is pacing when pain strikes.
24h dynamic electro cardiac chart: sinus heart rhythm, room early fight, room early burst, short burst room speed, room speed, arrhythmic pacing, arrhythmic pacing, arrhythmic pacing true fusion, arrhythmic pacing false fusion, double-chamber pacing false fusion.
no obvious abnormalities in the head CT.
diagnosis: primary trigexual nerve pain.
line PBC, the heart rate plummeted from 90 times/min to 70 times/min when the puncture needle entered the Meckel cavity through the round hole of the egg, which was reflected in the pacing heart rate, which was restored to about 80 beats/min.
can be seen in the operation of the balloon in a typical pear-shaped form, the effect of the operation is satisfied, pressure 150s after withdrawal of the balloon.
pain immediately disappears after surgery, and continuous electrostectric monitoring is sinus heart rhythm.
the next day.
court after 2d to complain of facial numbness, weakness of the chewing muscles, 3 months after the symptoms eased, during which the pain never returned.
1 Treatment of trigexual nerve pain-induced sinus arrest patients with skin puncture micro-balloon compression.
1A, 1B preoperative MRI lysoid, 1C preoperative MRI axis, visible cytobarbital artery compression extension, 1D surgery can be seen in the balloon is typical pear-shaped figure 2 trigexual nerve pain induced sinus arrest patients before and after pacemaker implantation electrostatial map.
2A Preoperative II. Leadlink: Long interval greater than 2.8s during trigesal nerve pain attack; 2B Postoperative II. Leadlink: Long interval after a series of atrial early fights during trigexual nerve pain attack, and pacing heart rhythm.
2C postoperative II. Leadlink: Trigebrate nerve pain attack is manifested as a continuous pacing heart rhythm 2. Discuss the diverse manifestations of trigebrate nerve pain, often involving the head and jaw and other parts, resulting in confusion with other painful diseases, which misdiagnosed as toothache, migraines, tension headaches are more common.
reported in this paper that the patient was misdiagnosed as a "headache" at the first visit, and later, according to its typical clinical manifestations, was corrected to diagnose trigemical nerve pain.
the outer part of his right eye as the "trigger point", cold stimulation, chewing, washing, brushing teeth, etc. can induce severe pain.
Research on the causes of trigemary neuropathy is not yet fully defined, at present vascular compression is the most accepted and recognized cause of the onset, of which the compression of arteries in the microcephaly is the most common, in addition to multiple sclerosis, cobweb cysts or adhesion can also lead to trigetrium nerve pain.
2.1 Etiology analysis of sinus arrest (1) by affecting ecstasy nerve stress: one of the common causes of sinus stop is increased ecstasy or cervical sinus allergy.
pain stimulation and nervousness are important causes of vasody nerve reflexes.
The patient's pain when the onset of severe, and because the condition is not healing, the seizure of excessive emotional tension, the seizure process induced a rise in the nervous tension of the lost walk, and then caused the heart to move too slowly, and even sinus stop.
in this process, the compression of the vertebral arteries on the myelin region may be an important cause of increased ecstasy nerve excitability.
(2) By inducing Trident-Cardiac Reflex (TCR): Trident nerve distribution areas are stimulated or pulled, it triggers Trident nerve-heart reflexes, which can manifest as arrhythm, anisopathic pacing, room conduction block, tiring, fainting, vomiting, and even cardiac arrest.
this may be related to the impulses of the trigemical nerve sensory nucleosis, which affects the ecstransic nerve motor nucleosis associated with it through neurons in the mesh structure.
The patient MRI showed that the cytomebrae arteries compressed the left myelin, may affect the regulation function of the myelin cardiovascular center (patient pacemaker implantation frequency, performance of various arrhythmic support this inference, and imaging performance is also consistent with it), to a certain extent to reduce the stimulation threshold induced by TCR, only pain attacks can induce this reflex, and then cause the patient to have a slow heart rate, and even cardiac arrest.
mri examination results of patients with 2.2 medical experience showed that the vertebral artery compression extension, when walking upward is closely related to the REZ region, considering trigebrate nerve pain as a result of vascular compression.
and patient MRI examination can be excluded from secondary causes such as trigemoma, multiple sclerosis, etc., to support the diagnosis of primary trigexual nerve pain.
patients were not satisfied with the second return to hospital due to medication, there was a strong demand for surgery.
the patient's age, poor eating through the mouth, poor nutritional status, general cardiopulmonary function and other factors, it is recommended to do PBC.
the patient's surgery center law plummeted, a pacing heart rhythm, considered due to the stimulation of trigemus-induced TCR.
and PBC preoperative pacemaker implantation is effective in avoiding the serious consequences of TCR-caused cardiac arrest and other malignant arrhythmic disorders, to prevent the occurrence of cardiac accidents during surgery, is one of the necessary preoperative preparations.
.