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  • Title: [Cardiovascular manifestations of chemical rhysolisis of the trigeminal nerve].
    Author: Igartua García L, Sánchez Torres G, González Mariscal G, Etulain Maldonado F, Méndez Venegas J.
    Journal: Arch Inst Cardiol Mex; 1979; 49(6):1073-89. PubMed ID: 549521.
    Abstract:
    Twelve chemical rhyzolisis (surgical instilation of 10 c.c. of 15% NaCl solution) of trigeminal nerve were performed in 11 patients with trigeminal neuralgia resistent to medical treatment. Before and at least in the first 30 minutes after instilation the following parameters were monitorized: electrocardiogram, electroencephalogram, intrarradial arterial pressure and venous central pressure. In 10 cases after a 2.8 +/- 2.4 seg. latency period the following arrhythmias appeared (in paragraphs number of cases): sinus bradicardia, sinoauricular block, sinus arrest, atrial-ventricular block and atrial pacemaker migration. During sinus arrest (8 episodes in 4 cases; mean duration 17.6 secs.) slow, high voltage waves appeared in the electroencephalographic tracings. Ventricular scapes were not seen at the end of the sinus pauses. In 6 cases after this slow arrhythmic phase the following arrhythmias were observed: ventricular premature beats, atrial premature beats, sinus tachycardia, bidirectional ventricular tachycardia, and nodal tachycardia. All cases exhibited an elevation of mean arterial pressure after instilation of the nerve which was preceded by a short period of hypertension in 4 occasions. Average and standard deviations changes of systolic, diastolic and mean blood pressure (mm of Hg), pulse (beats/minute) and central venous pressure (cms of H2O) during the procedure were 46.7 +/- 29.3, 23.0 +/- 13.3, 34.1 +/- 16.4, 25.8 +/- 16.2 and 6.6 +/- 5.8, respectively (p less than or equal to 0.001) in all changes but the last ones, less than or equal to 0.05). Physiopathologic considerations of this autonomic crises are done.
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