Specialists in trigeminal neuralgias?neuropathic pain?

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Smilemaker100

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I was wondering if anyone in this forum has subspecialized in trigeminal neuralgias or neuropathic pain research.

I am very interested in pain research primarily from a clinical perspective as I am a dentist and secondarily because of the many pain research projects I have been involved with over the years. Although I don't work in the research milieu any longer, I am fascinated by pain research for my own intellectual curiousity.

As a graduate student, I had the opportunity to work on a pilot study involving "chronic constriction injuries" (CCI) of the sciatic nerves in rats , which is an internationally recognized neuropathic pain model developed by the professor I was working with. The landmark study on CCI is the following: Bennett, G.J. and Xie, Y.-K.: "A peripheral mononeuropathy in rat that produces disorders of pain sensation like those seen in man". Pain 33: 87-107, 1988

http://www.hosppract.com/issues/1998/10/bennett.htm

I also had the chance to work on some neuro based research with another professor which was related to the trigeminal thalamo-cortical somatosensory pathway and tried to relate it to the infamous studies done by Pons et al. , "Massive Cortical Reorganization After Sensory Deafferentation in Adult Macaques". Science, Vol. 252, 1991, pp. 1857-1860a. This landmark study hinted at possible neuroplasticity occuring in macaque monkeys that had sustained some deafferentation of many cervical nerves and exhibited neuropathic pain not unlike "phantom limb pain".

http://apu.sfn.org/content/Membership1/MemberObituaries/ObituariesArchive/pons.htm

Anyone on this forum involved with research pertaining to pain conditions restricted to the head & neck region?

Comments?

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I am not personally involved with this type of research, but i can point you to someone in academics who i heard at a review course speaking about the topics you mentioned. You can look their emails up pretty easily.

Robert M. Levy is a neurosurgeon. Kenneth Candido is a pain/anesthesiology specialist.

T
 
probably one of the most famous neuropathic experts nationally is
Anne-Louise Oaklander - look her up.
 
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Doctodd said:
I am not personally involved with this type of research, but i can point you to someone in academics who i heard at a review course speaking about the topics you mentioned. You can look their emails up pretty easily.

Robert M. Levy is a neurosurgeon. Kenneth Candido is a pain/anesthesiology specialist.

T

Thanks, T. I briefly read Dr Levy's abstracts on the experimental pharmacological interventions of neuropathic pain syndromes. I was fascinated by his research on neurotropic HIV-1 strains as I majored in micro as an undergrad and have always held a fascination on the pathological effects of HIV as well as it's genetic mutations.

Where did you attend review courses on pain research ?
 
Tenesma said:
probably one of the most famous neuropathic experts nationally is
Anne-Louise Oaklander - look her up.

Thanks. I briefly read about her. She's involved with interesting work on diabetic neuropathies and postherpetic neuralgia.
 
I met both of them at the Dannemiller review course in Chicago in August. But I was one of hundreds of people at the course, so i wouldnt expect them to know who i am. Since they both work in Chicago, it was easy for them to participate. Both seemed easily approachable as well.

T
 
Doctodd said:
I met both of them at the Dannemiller review course in Chicago in August. But I was one of hundreds of people at the course, so i wouldnt expect them to know who i am. Since they both work in Chicago, it was easy for them to participate. Both seemed easily approachable as well.

T

Is the Dannemiller review course for anesthesiologists only ( I googled it) or other health professionals as well? I am interested in pain research and management. Thanks.
 
Smilemaker100 said:
I am interested in pain research and management. Thanks.

Are you more interested in the clinical aspects or doing research? Have you considered doing a dental anesthesiology residency, then maybe a pain management fellowship? Or do you want to pursue a MSc or PhD in pain manangement or neuroscience?
 
OzDDS said:
Are you more interested in the clinical aspects or doing research? Have you considered doing a dental anesthesiology residency, then maybe a pain management fellowship? Or do you want to pursue a MSc or PhD in pain manangement or neuroscience?

At the moment, I am content with clinical work and taking CE courses in pain management. I already hold an M.Sc in which I did some neuro work. I don't see myself pursuing any more degrees at the moment :rolleyes: :laugh:
But who knows? Maybe at a future point in time I may specialize in something. I have other priorities right now...
 
Smilemaker100 said:
I was wondering if anyone in this forum has subspecialized in trigeminal neuralgias or neuropathic pain research.

I am very interested in pain research primarily from a clinical perspective as I am a dentist and secondarily because of the many pain research projects I have been involved with over the years. Although I don't work in the research milieu any longer, I am fascinated by pain research for my own intellectual curiousity.

As a graduate student, I had the opportunity to work on a pilot study involving "chronic constriction injuries" (CCI) of the sciatic nerves in rats , which is an internationally recognized neuropathic pain model developed by the professor I was working with. The landmark study on CCI is the following: Bennett, G.J. and Xie, Y.-K.: "A peripheral mononeuropathy in rat that produces disorders of pain sensation like those seen in man". Pain 33: 87-107, 1988

http://www.hosppract.com/issues/1998/10/bennett.htm

I also had the chance to work on some neuro based research with another professor which was related to the trigeminal thalamo-cortical somatosensory pathway and tried to relate it to the infamous studies done by Pons et al. , "Massive Cortical Reorganization After Sensory Deafferentation in Adult Macaques". Science, Vol. 252, 1991, pp. 1857-1860a. This landmark study hinted at possible neuroplasticity occuring in macaque monkeys that had sustained some deafferentation of many cervical nerves and exhibited neuropathic pain not unlike "phantom limb pain".

http://apu.sfn.org/content/Membership1/MemberObituaries/ObituariesArchive/pons.htm

Anyone on this forum involved with research pertaining to pain conditions restricted to the head & neck region?

Comments?


Smile maker,

A while back I attended a pain conference in California. A chiropractic neurologist there referenced this very study you are mentioning. He stated that individuals with centrally mediated trigeminal pain suffer from cervical large diameter deafferentation. He noted that by reestablishing normal joint mechanics in the c-spine that he was able to resolve trigeminal neuropathic pain. Of course he could only reference this study and had no real randomized clinical trials to support this claim. Likewise all his experience was self limited. However, I do find it interesting that dorsal column fibers from the upper c-spine do fire to the same vpm nucleus in the thalamus that may have modulation on pain perception. I hope this helps. :D
 
analgesic said:
Smile maker,

A while back I attended a pain conference in California. A chiropractic neurologist there referenced this very study you are mentioning. He stated that individuals with centrally mediated trigeminal pain suffer from cervical large diameter deafferentation. He noted that by reestablishing normal joint mechanics in the c-spine that he was able to resolve trigeminal neuropathic pain. Of course he could only reference this study and had no real randomized clinical trials to support this claim. Likewise all his experience was self limited. However, I do find it interesting that dorsal column fibers from the upper c-spine do fire to the same vpm nucleus in the thalamus that may have modulation on pain perception. I hope this helps. :D

Thanks, for sharing the info on that conference. :) Do you know the name of this chiropractic neurologist?

Yes, I have heard of the theory of dorsal column fibers from the upper C-spine firing to the VPM nucleus which may have modulation on pain perception. Some evidence strongly suggests that C2 and V3 (mandibular nerve) have a close relationship in the thalamus but I am not entirely sure if there is very solid evidence of C2 being represented in the VPM nucleus yet. A part of my M.Sc thesis actually discussed this.

A few older studies have shown that there is overlapping C2 and V3 at the level of the subnucleus caudalis in the spinal tract of nerve V which relays pain information to higher stations in the somatosensory pathway.

Denny -Brown,D. and N.Yanagisawa (1973) The function of the descending root of the fifth nerve. Brain, 96:783-814.

Sherrington, C.S (1979) On the distribution of the sensory nerve roots. In :Selective writings of Sir Charles Sherrington (Denny-Brown,D.ed)pp31-93. London:Oxford University Press.

Here is a recent abstract on cervical and trigeminal convergence! I got to get my hands on this article!

"Clinically, trigeminal activation produces symptoms in the trigeminal and cervical territory and cervical activation produces symptoms in the cervical and trigeminal territory."

http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=12946291&query_hl=4

and more...
http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=12946290&query_hl=4
http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=11422092&query_hl=4
 
Smilemaker100 said:
Thanks, for sharing the info on that conference. :) Do you know the name of this chiropractic neurologist?

Yes, I have heard of the theory of dorsal column fibers from the upper C-spine firing to the VPM nucleus which may have modulation on pain perception. Some evidence strongly suggests that C2 and V3 (mandibular nerve) have a close relationship in the thalamus but I am not entirely sure if there is very solid evidence of C2 being represented in the VPM nucleus yet. A part of my M.Sc thesis actually discussed this.

A few older studies have shown that there is overlapping C2 and V3 at the level of the subnucleus caudalis in the spinal tract of nerve V which relays pain information to higher stations in the somatosensory pathway.

Denny -Brown,D. and N.Yanagisawa (1973) The function of the descending root of the fifth nerve. Brain, 96:783-814.

Sherrington, C.S (1979) On the distribution of the sensory nerve roots. In :Selective writings of Sir Charles Sherrington (Denny-Brown,D.ed)pp31-93. London:Oxford University Press.

Here is a recent abstract on cervical and trigeminal convergence! I got to get my hands on this article!

"Clinically, trigeminal activation produces symptoms in the trigeminal and cervical territory and cervical activation produces symptoms in the cervical and trigeminal territory."

http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=12946291&query_hl=4

and more...
http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=12946290&query_hl=4
http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=11422092&query_hl=4


Smile maker,

I believe the physician's name was Dr. Helmi. I know he is currently doing a PM&R residency at Case Western University. You might try calling the department there (216)778-7800. I hope this helps!!!!
 
analgesic said:
Smile maker,

I believe the physician's name was Dr. Helmi. I know he is currently doing a PM&R residency at Case Western University. You might try calling the department there (216)778-7800. I hope this helps!!!!

Thanks,analgesic. I wasn't thinking of personally contacting him ! :laugh: I was interested in reading any articles he may have written on his work.
 
Regarding the Dannemiller course, it is very very fast paced and concentrated. It might be a waste if you dont already have a good foundation in pain.

The ABPM has a review course in San Diego in February, and the ASRA has review course throughout the year that are more of a conference format. These may be another option to consider.

T
 
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