The Trigeminocardiac Reflex? Severe Bradycardia Secondary to Facial Trauma: A Case Report

Introduction: The trigeminocardiac reflex (TCR), a physiologic response to irritation of the branches of the trigeminal nerve, was first described in humans in 1870. Gastric hypermotility, hypotension, bradycardia, and even asystole have been reported in response to surgical manipulation of the trig...

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Main Authors: Boris Penev, Hallmon Hughes, Katherine Scarpino, Daniel J. Ritter
Format: Article
Language:English
Published: eScholarship Publishing, University of California 2025-07-01
Series:Clinical Practice and Cases in Emergency Medicine
Online Access:https://escholarship.org/uc/item/97k585gq
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author Boris Penev
Hallmon Hughes
Katherine Scarpino
Daniel J. Ritter
author_facet Boris Penev
Hallmon Hughes
Katherine Scarpino
Daniel J. Ritter
author_sort Boris Penev
collection DOAJ
description Introduction: The trigeminocardiac reflex (TCR), a physiologic response to irritation of the branches of the trigeminal nerve, was first described in humans in 1870. Gastric hypermotility, hypotension, bradycardia, and even asystole have been reported in response to surgical manipulation of the trigeminal nerve and its branches, but literature is limited in patients not undergoing surgery. Although effects are generally transient and benign, TCR can present a significant diagnostic and therapeutic challenge in patients undergoing surgical manipulation of the trigeminal nerve and its branches. Case Report: We describe a case of severe bradycardia secondary to facial trauma causing hemodynamic compromise and diagnostic uncertainty. Conclusion: This case highlights a possible case of TCR, as well as therapeutic considerations, in a patient presenting to the emergency department with severe facial trauma.
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series Clinical Practice and Cases in Emergency Medicine
spelling doaj-art-005a2f39be08407bbc5306704fbd4c8f2025-08-20T03:02:53ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2025-07-019332232510.5811/cpcem.43035cpcem-9-322The Trigeminocardiac Reflex? Severe Bradycardia Secondary to Facial Trauma: A Case ReportBoris Penev0Hallmon Hughes1Katherine Scarpino2Daniel J. Ritter3Medical University of South Carolina, Department of Emergency Medicine, Charleston, South CarolinaMedical University of South Carolina, College of Medicine, Charleston, South CarolinaMedical University of South Carolina, Department of Emergency Medicine, Charleston, South CarolinaMedical University of South Carolina, Department of Emergency Medicine, Charleston, South CarolinaIntroduction: The trigeminocardiac reflex (TCR), a physiologic response to irritation of the branches of the trigeminal nerve, was first described in humans in 1870. Gastric hypermotility, hypotension, bradycardia, and even asystole have been reported in response to surgical manipulation of the trigeminal nerve and its branches, but literature is limited in patients not undergoing surgery. Although effects are generally transient and benign, TCR can present a significant diagnostic and therapeutic challenge in patients undergoing surgical manipulation of the trigeminal nerve and its branches. Case Report: We describe a case of severe bradycardia secondary to facial trauma causing hemodynamic compromise and diagnostic uncertainty. Conclusion: This case highlights a possible case of TCR, as well as therapeutic considerations, in a patient presenting to the emergency department with severe facial trauma.https://escholarship.org/uc/item/97k585gq
spellingShingle Boris Penev
Hallmon Hughes
Katherine Scarpino
Daniel J. Ritter
The Trigeminocardiac Reflex? Severe Bradycardia Secondary to Facial Trauma: A Case Report
Clinical Practice and Cases in Emergency Medicine
title The Trigeminocardiac Reflex? Severe Bradycardia Secondary to Facial Trauma: A Case Report
title_full The Trigeminocardiac Reflex? Severe Bradycardia Secondary to Facial Trauma: A Case Report
title_fullStr The Trigeminocardiac Reflex? Severe Bradycardia Secondary to Facial Trauma: A Case Report
title_full_unstemmed The Trigeminocardiac Reflex? Severe Bradycardia Secondary to Facial Trauma: A Case Report
title_short The Trigeminocardiac Reflex? Severe Bradycardia Secondary to Facial Trauma: A Case Report
title_sort trigeminocardiac reflex severe bradycardia secondary to facial trauma a case report
url https://escholarship.org/uc/item/97k585gq
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