Skip to content
2000
Volume 20, Issue 9
  • ISSN: 1574-888X
  • E-ISSN: 2212-3946

Abstract

Introduction/Objectives

Trigeminal neuralgia (TN) is an extremely painful condition without an established treatment other than symptom suppressive medications or temporary relief from corticosteroid injections. Mesenchymal Stem Cells (MSCs) have demonstrated the ability to enhance healing and reduce inflammation and pain without side effects. Our objective was to evaluate the safety and efficacy of CT-guided foramen ovale MSC injection in the treatment of TN.

Case Report

A 48-year-old woman presented with a 22-year history of severe TN. Previous treatments, including microvascular decompression, acupuncture, chiropractic adjustment, and hypnotism had failed. Medications decreased pain but produced severe bothersome mental clouding. After proper informed consent, the patient elected trigeminal nerve injection in the foramen ovale with AlloRx (vitrobiopharma.com Golden Colorado) umbilical cord-derived mesenchymal stem cells (MSCs). An experienced pain specialist with previous experience using CT guidance with sedation to inject the trigeminal nerve in the foramen ovale with corticosteroids, performed the injection using 20 million MSCs. The patient had no adverse events or complications related to the treatment. At 1 month post treatment the patient reported dramatically reduced pain/tingling, and no longer needed medication resulting in resolution of her mental clouding. At 12 months post-treatment, some symptoms recurred, but the patient maintained substantial cognitive improvements and required a reduced dose of medication.

Conclusion

We have demonstrated for the first time that CT guided MSC injection into the foramen ovale results in significant improvement in trigeminal neuralgia without side effects.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/cscr/10.2174/011574888X335230241111061649
2024-12-12
2025-12-09

  • From This Site

    /content/journals/cscr/10.2174/011574888X335230241111061649
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. ArayaE.I. ClaudinoR.F. PiovesanE.J. ChichorroJ.G. Trigeminal neuralgia: Basic and clinical aspects.Curr. Neuropharmacol.202018210911910.2174/1570159X1766619101009435031608834
     [Google Scholar]
  2. NovaC. ZakrzewskaJ. RiordainR. BakerS. “They could have cut my head off and i wouldn’t have cared”—a qualitative study of patient experiences and the impact of trigeminal neuralgia.J. Oral Facial Pain Headache202236318920510.11607/ofph.311036445910
     [Google Scholar]
  3. AlwardianM. ChrysikosD. SamolisA. PapachristouA. SpartalisE. PiagkouM. TroupisT. Trigeminal neuralgia and potential correlations with anatomical variations of the trigeminal nerve.Acta Med. Acad.202150229229910.5644/ama2006‑124.34434847681
     [Google Scholar]
  4. Shankar KikkeriN. NagalliS. Trigeminal Neuralgia.StatPearls.Treasure Island, FLStatPearls Publishing2024
     [Google Scholar]
  5. BartindaleM. MohamedA. BellJ. KircherM. HillJ. AndersonD. LeonettiJ. Neurotologic complications following microvascular decompression: A retrospective study.J. Neurol. Surg. B Skull Base202081103704210.1055/s‑0039‑167768832021748
     [Google Scholar]
  6. CoteD.J. DasenbrockH.H. GormleyW.B. SmithT.R. DunnI.F. Adverse events after microvascular decompression: A national surgical quality improvement program analysis.World Neurosurg.2019128e884e89410.1016/j.wneu.2019.05.02231082546
     [Google Scholar]
  7. YueY. ZhaoZ.R. LiuD.C. LiuH.J. LuD.L. ZhangH. JinP. Life-threatening complications after microvascular decompression procedure: Lessons from a consecutive series of 596 patients.J. Clin. Neurosci.202186647010.1016/j.jocn.2021.01.01433775349
     [Google Scholar]
  8. LambruG. ZakrzewskaJ. MatharuM. Trigeminal neuralgia: A practical guide.Pract. Neurol.202121539240210.1136/practneurol‑2020‑00278234108244
     [Google Scholar]
  9. MaanJ.S. Carbamazepine.StatPearls.Treasure Island, FLStatPearls Publishing2024
     [Google Scholar]
  10. PellockJ.M. Carbamazepine side effects in children and adults.Epilepsia198728s3Suppl. 3S64S7010.1111/j.1528‑1157.1987.tb05780.x2961558
     [Google Scholar]
  11. Molina-OlierO Marsiglia-PérezD Alvis-MirandaH Surgical treatment of trigeminal neuralgia in adults.Cir Cir.202290454855510.24875/CIRU.2000077235944472
     [Google Scholar]
  12. Nicola MontanoN. ConfortiG. Di BonaventuraR. MeglioM. FernandezE. PapacciF. Advances in diagnosis and treatment of trigeminal neuralgia.Ther. Clin. Risk Manag.20151128929910.2147/TCRM.S3759225750533
     [Google Scholar]
  13. RosénA. TardastA. ShiT.J. How far have we come in the field of nerve regeneration after trigeminal nerve injury?Curr. Oral Health Rep.20163430931310.1007/s40496‑016‑0115‑x27891301
     [Google Scholar]
  14. XuR. XieM.E. JacksonC.M. Trigeminal neuralgia: Current approaches and emerging interventions.J. Pain Res.2021143437346310.2147/JPR.S33103634764686
     [Google Scholar]
  15. ColletC. HaenP. LaversanneS. BrignolL. ThiéryG. Trigeminal neuralgia: A new therapy?Med. Hypotheses20138161088108910.1016/j.mehy.2013.10.01024199950
     [Google Scholar]
  16. GuoW. ShiH. WenX. QianT. A simple method for foramen ovale puncture based on preoperative image simulation in percutaneous microcompression of the trigeminal ganglion.Oper. Neurosurg. 202222531532110.1227/ons.000000000000012335240674
     [Google Scholar]
  17. SunZ. LiuL. LiuH. LuoF. Effect of CT-guided gasserian ganglion block with local anesthetics and steroids on acute/subacute zoster-related trigeminal neuralgia: A multicenter retrospective study.J. Pain Res.2022152303231310.2147/JPR.S37525735974906
     [Google Scholar]
  18. KimN. ChoS.G. New strategies for overcoming limitations of mesenchymal stem cell-based immune modulation.Int. J. Stem Cells201581546810.15283/ijsc.2015.8.1.5426019755
     [Google Scholar]
  19. MurphyM.B. MoncivaisK. CaplanA.I. Mesenchymal stem cells: Environmentally responsive therapeutics for regenerative medicine.Exp. Mol. Med.20134511e5410.1038/emm.2013.9424232253
     [Google Scholar]
  20. RusuE. NeculaL.G. NeaguA.I. AlecuM. StanC. AlbulescuR. TanaseC.P. Current status of stem cell therapy: Opportunities and limitations.Turk. J. Biol.20164095596710.3906/biy‑1506‑95
     [Google Scholar]
  21. SakaiK. YamamotoA. MatsubaraK. NakamuraS. NaruseM. YamagataM. SakamotoK. TauchiR. WakaoN. ImagamaS. HibiH. KadomatsuK. IshiguroN. UedaM. Human dental pulp-derived stem cells promote locomotor recovery after complete transection of the rat spinal cord by multiple neuro-regenerative mechanisms.J. Clin. Invest.20121221809022133879
     [Google Scholar]
  22. ChoumerianouD.M. DimitriouH. KalmantiM. Stem cells: Promises versus limitations.Tissue Eng. Part B Rev.2008141536010.1089/teb.2007.021618454634
     [Google Scholar]
  23. HouKegui S.M. JianWang SongWenpeng S.M Pluripotent stem cells-derived Schwann cells: An innovative strategy for trigeminal neuralgia?Int. J. of Sur.202411096005600610.1097/JS9.0000000000001735
     [Google Scholar]
  24. LiuM. LiK. WangY. ZhaoG. JiangJ. Stem cells in the treatment of neuropathic pain: Research progress of mechanism.Stem Cells Int.2020202011310.1155/2020/886125133456473
     [Google Scholar]
  25. NaselloM. SchiròG. CrapanzanoF. BalistreriC.R. Stem cells and other emerging agents as innovative “drugs” in neurodegenerative diseases: Benefits and limitations.Rejuvenation Res.201821212314010.1089/rej.2017.194628728479
     [Google Scholar]
  26. XuP. LinX. DongX. LiuY. WangZ. WangS. Trigeminal nerve-derived substance P regulates limbal stem cells by the PI3K-AKT pathway.iScience202326510668810.1016/j.isci.2023.10668837187698
     [Google Scholar]
  27. RenK. VickersR. MurilloJ. RuparelN.B. Revolutionizing orofacial pain management: The promising potential of stem cell therapy.Front. Pain Res.20234123963310.3389/fpain.2023.123963338028430
     [Google Scholar]
  28. VickersR. KarstenE. LilischkisR. FloodJ. A preliminary report on stem cell therapy for neuropathic pain in humans.J. Pain Res.2014725526310.2147/JPR.S6336124855388
     [Google Scholar]
  29. GentileP. CalabreseC. De AngelisB. PizzicannellaJ. KothariA. GarcovichS. Impact of the different preparation methods to obtain human adipose-derived stromal vascular fraction cells (AD-SVFs) and human adipose-derived mesenchymal stem cells (AD-MSCs): Enzymatic digestion versus mechanical centrifugation.Int. J. Mol. Sci.20192021547110.3390/ijms2021547131684107
     [Google Scholar]
  30. MehranfarS. Abdi RadI. MostafaviE. AkbarzadehA. The use of stromal vascular fraction (SVF), platelet-rich plasma (PRP) and stem cells in the treatment of osteoarthritis: An overview of clinical trials.Artif. Cells Nanomed. Biotechnol.201947188289010.1080/21691401.2019.157671030887856
     [Google Scholar]
  31. RaJ.C. ShinI.S. KimS.H. KangS.K. KangB.C. LeeH.Y. KimY.J. JoJ.Y. YoonE.J. ChoiH.J. KwonE. Safety of intravenous infusion of human adipose tissue-derived mesenchymal stem cells in animals and humans.Stem Cells Dev.20112081297130810.1089/scd.2010.046621303266
     [Google Scholar]
  32. TonreyT MusickJ DeanR Comparison of adipose stromal vascular fraction and placental cell extract to expanded adipose, placental, and umbilical cord mesenchymal stem cells.2018Available from: https://www.vitrobiopharma.com/blogs/white-papers/comparison-of-adipose-stromal-vascular-fraction-and-placental- cell-extract-to-expanded-adipose-placental-and-umbilical- cord-mesenchymal-stem-cells
  33. KramperaM. FranchiniM. PizzoloG. ApriliG. Mesenchymal stem cells: From biology to clinical use.Blood Transfus.20075312012910.2450/2007.0029‑0719204764
     [Google Scholar]
  34. YaghoubiY. MovassaghpourA. ZamaniM. TalebiM. MehdizadehA. YousefiM. Human umbilical cord mesenchymal stem cells derived-exosomes in diseases treatment.Life Sci.201923311673310.1016/j.lfs.2019.11673331394127
     [Google Scholar]
  35. ZhangJ. HuangX. WangH. LiuX. ZhangT. WangY. HuD. The challenges and promises of allogeneic mesenchymal stem cells for use as a cell-based therapy.Stem Cell Res. Ther.20156123410.1186/s13287‑015‑0240‑926620426
     [Google Scholar]
  36. BaiX. ZhangX. WangC. LiuY. LiuX. FanY. ZhangX. Stem cells from human exfoliated deciduous teeth attenuate trigeminal neuralgia in rats.Stem Cells Int.2021202111410.1155/2021/881988433531911
     [Google Scholar]
  37. YangZ. WangC. ZhangX. LiJ. ZhangZ. TanZ. WangJ. ZhangJ. BaiX. Stem cells from human exfoliated deciduous teeth attenuate trigeminal neuralgia in rats by inhibiting endoplasmic reticulum stress.Korean J. Pain202235438339010.3344/kjp.2022.35.4.38336175337
     [Google Scholar]
  38. CostaC.M.M. SantosD.S. OpretzkaL.C.F. de Assis SilvaG.S. SantosG.C. EvangelistaA.F. SoaresM.B.P. VillarrealC.F. Different mechanisms guide the antinociceptive effect of bone marrow-mononuclear cells and bone marrow-mesenchymal stem/stromal cells in trigeminal neuralgia.Life Sci.202435412294410.1016/j.lfs.2024.12294439111567
     [Google Scholar]
  39. IslamJ. KcE. SoK.H. KimS. KimH.K. ParkY.Y. ParkY.S. Modulation of trigeminal neuropathic pain by optogenetic inhibition of posterior hypothalamus in CCI-ION rat.Sci. Rep.202313148910.1038/s41598‑023‑27610‑736627362
     [Google Scholar]
  40. YanX. LiuY. YuS. HuangD. HuR. Repair effects of bone marrow mesenchymal stem cells on demyelination of trigeminal ganglion in rats with trigeminal neuralgia.J. Pain Res.20221561362210.2147/JPR.S34790735250305
     [Google Scholar]
/content/journals/cscr/10.2174/011574888X335230241111061649
Loading
CT-guided Foramen Ovale Injection of Mesenchymal Stem Cells: First Human Case Report of Trigeminal Neuralgia Relief
Curr Stem Cell Res Ther 20, 1024 (2025); https://doi.org/10.2174/011574888X335230241111061649
/content/journals/cscr/10.2174/011574888X335230241111061649
/content/journals/cscr/10.2174/011574888X335230241111061649
Loading

Data & Media loading...


  • Article Type:     Case Report
Keyword(s): case report, computed-tomography guided, foramen ovale, relief; Mesenchymal stem cells; trigeminal neuralgia

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test