The Promise and Future of the Trigeminocardiac Reflex

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Systems Neuroscience".

Deadline for manuscript submissions: closed (15 November 2020) | Viewed by 2666

Special Issue Editors


E-Mail Website
Guest Editor
Department of Primary Care, University of Zurich, Zürich 8038, Switzerland
Interests: trigeminocardiac reflex; autonomous reflex; neuroscience

E-Mail Website
Guest Editor
Department of Primary Care, University of Zurich, Zürich 8038, Switzerland
Interests: trigeminocardiac reflex; autonomous reflex; brainstem;trigeminal nerve; bradycardy; hypotony

E-Mail Website
Guest Editor
Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, Toronto M5T2S8, ON, Canada
Interests: trigeminocardiac reflex; autonomous reflex; brainstem;trigeminal nerve; bradycardy; hypotony

Special Issue Information

Dear Colleagues,

Since trigeminocardiac reflex (TCR) was first described in 1999, it has gained enormous interest all over the world and is mentioned as a potential complication in nearly all textbooks about neuroanaethesia or skull base surgery. We are also the first to have pushed TCR as a cause of surgical complications in non-surgical disorders. This has opened the window for research and gives promise to the potential of the TCR.

In this Special Issue, we will use this widening of the TCR and try to better understand the future potential of the TCR from a wide spectrum of views (basic research, anesthesia, surgery, neurology, etc.).

Dr. Bernhard Schaller
Prof. Thomas Rosemann
Prof. Tumul Chowdhury
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Trigeminocardiac reflex
  • Skull base
  • Neurology
  • bradycardia

Published Papers (1 paper)

Order results
Result details
Select all
Export citation of selected articles as:

Other

9 pages, 1243 KiB  
Case Report
Trigeminocardiac Reflex Induced by Maxillary Nerve Stimulation during Sphenopalatine Ganglion Implantation: A Case Series
by Yousef Hammad, Allison Mootz, Kevin Klein and John R. Zuniga
Brain Sci. 2020, 10(12), 973; https://doi.org/10.3390/brainsci10120973 - 11 Dec 2020
Cited by 3 | Viewed by 2362
Abstract
Background: The trigeminocardiac reflex (TCR) is a brainstem reflex following stimulation of the trigeminal nerve, resulting in bradycardia, asystole and hypotension. It has been described in maxillofacial and craniofacial surgeries. This case series highlights TCR events occurring during sphenopalatine ganglion (SPJ) neurostimulator implantation [...] Read more.
Background: The trigeminocardiac reflex (TCR) is a brainstem reflex following stimulation of the trigeminal nerve, resulting in bradycardia, asystole and hypotension. It has been described in maxillofacial and craniofacial surgeries. This case series highlights TCR events occurring during sphenopalatine ganglion (SPJ) neurostimulator implantation as part of the Pathway CH-2 clinical trial “Sphenopalatine ganglion Stimulation for Treatment of Chronic Cluster Headache”. Methods: This is a case series discussing sphenopalatine ganglion neurostimulator implantation in the pterygopalatine fossa as treatment for intractable cluster headaches. Eight cases are discussed with three demonstrating TCR events. All cases received remifentanil and desflurane for anesthetic maintenance. Results: Each patient with a TCR event experienced severe bradycardia. In two cases, TCR resolved with removal of the introducer, while the third case’s TCR event resolved with both anticholinergic treatment and surgical stimulation cessation. Conclusion: Each TCR event occurred before stimulation of the fixed introducer device, suggesting the cause for the TCR events was mechanical in origin. Due to heightened concern for further TCR events, all subsequent cases had pre-anesthesia external pacing pads placed. Resolution can occur with cessation of surgical manipulation and/or anticholinergic treatment. Management of TCR events requires communication between surgical teams and anesthesia providers, especially during sphenopalatine ganglion implantation when maxillary nerve stimulation is possible. Full article
(This article belongs to the Special Issue The Promise and Future of the Trigeminocardiac Reflex)
Show Figures

Graphical abstract

Back to TopTop