Trigeminocardiac reflex: a unique case of recurrent asystole during bilateral trigeminal sensory root rhizotomy

Background: The trigeminocardiac reflex is the sudden-onset of dysrhythmia and hypotension during manipulation of any of the branches of the trigeminal nerve. The trigeminal nerve and cardioinhibitory vagus nerve constitute the afferent and efferent pathways in the reflex arc. The trigeminocardiac r...

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Bibliographic Details
Published in:Journal of cranio-maxillo-facial surgery 2002-04, Vol.30 (2), p.108-111
Main Authors: Cha, S.T., Eby, J.B., Katzen, J.T., Shahinian, H.K.
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Cranial Fossa, Posterior
Dentistry
Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics
Heart Arrest - etiology
Hemangioma - complications
Humans
Infratentorial Neoplasms - complications
Male
Medical sciences
Otorhinolaryngology (head neck, general aspects and miscellaneous)
Otorhinolaryngology. Stomatology
Pain, Intractable - etiology
Pain, Intractable - surgery
Recurrence
Reflex - physiology
Reflex, Oculocardiac - physiology
Rhizotomy - adverse effects
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the upper aerodigestive tract
Trigeminal Nerve - physiology
Trigeminal Nerve - surgery
Trigeminal Neuralgia - etiology
Trigeminal Neuralgia - surgery
Tumors
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Summary:Background: The trigeminocardiac reflex is the sudden-onset of dysrhythmia and hypotension during manipulation of any of the branches of the trigeminal nerve. The trigeminal nerve and cardioinhibitory vagus nerve constitute the afferent and efferent pathways in the reflex arc. The trigeminocardiac reflex has been reported to occur during craniofacial surgery, balloon-compression rhizolysis of the trigeminal ganglion, and tumour resection in the cerebellopontine angle. Patient & Method: A 2-year-old male patient with haemangioma near the sella turcica underwent rhizotomies of both sides of the dorsal sensory roots, of the trigeminal nerves for palliation of intractable trigeminal pain. Results: In this report, we experienced two unexpected episodes of asystole after transection of the sensory roots of the trigeminal nerves. Conclusion: Sectioning of the intracranial dorsal sensory root of the trigeminal nerve provides clear evidence of the central role of the trigeminal nerve as the afferent pathway of the trigeminocardiac reflex arc.
ISSN:1010-5182
1878-4119
DOI:10.1054/jcms.2001.0264