Sadeghi Parrish, Papay Francis A, Vidimos Allison T
Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Dermatol Surg. 2004 May;30(5):807-12; discussion 812. doi: 10.1111/j.1524-4725.2004.30220.x.
Trigeminal trophic syndrome is a unilateral, frequently crescent-shaped neurotrophic ulceration of the face occurring after injury to the trigeminal nerve. The appearance of the ulcers resembles other disease entities such as granulomatous disease, neoplasm, vasculitis, infection, and factitial dermatitis.
The objectives of this study are to increase awareness of this disorder and to emphasize the importance of eliciting a thorough neurologic history when evaluating facial ulcerations.
Four cases are reported and, using MEDLINE, the English and non-English literature from 1982 to 2002 is reviewed.
Including this report, there have been 60 cases of trigeminal trophic syndrome reported from 1982 to 2002. The age at presentation ranged from 14 months to 93 years. Time of onset from injury to the trigeminal ganglion or its branches and the development of the ulcers ranged from 2 weeks to 30 years. One-third of the patients had undergone trigeminal nerve ablation for the treatment of trigeminal neuralgia and another third had a history of stroke. Other causes included craniotomy, head trauma, herpes infection.
The majority of cases of trigeminal trophic syndrome are associated with a history of stroke or trigeminal nerve ablation. Successful surgical outcome can be achieved if the underlying neurologic pathology is addressed before the reconstructive procedure.
三叉神经营养综合征是一种在三叉神经损伤后出现的单侧面部、常呈新月形的神经营养性溃疡。这些溃疡的外观类似于其他疾病实体，如肉芽肿病、肿瘤、血管炎、感染和人工皮炎。
本研究的目的是提高对这种疾病的认识，并强调在评估面部溃疡时了解全面神经病史的重要性。
报告了4例病例，并使用MEDLINE对1982年至2002年的英文和非英文文献进行了回顾。
包括本报告在内，1982年至2002年共报告了60例三叉神经营养综合征病例。发病年龄从14个月到93岁不等。从三叉神经节或其分支损伤到溃疡出现的时间间隔从2周至30年不等。三分之一的患者因治疗三叉神经痛接受过三叉神经切除术，另有三分之一有中风病史。其他病因包括开颅手术、头部外伤、疱疹感染。
大多数三叉神经营养综合征病例与中风或三叉神经切除术病史有关。如果在重建手术前解决潜在的神经病理学问题，可取得成功的手术效果。
