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三叉神经痛和舌咽神经痛:牙医遇到的两种口腔面部疼痛综合征。

Trigeminal neuralgia and glossopharyngeal neuralgia: two orofacial pain syndromes encountered by dentists.

作者信息

Horowitz Michael, Horowitz Martin, Ochs Mark, Carrau Ricardo, Kassam Amin

机构信息

Department of Neurosurgery, University of Pittsburgh Medical Center, Presbyterian University Hospital, PA 15213-2582, USA.

出版信息

J Am Dent Assoc. 2004 Oct;135(10):1427-33; quiz 1468. doi: 10.14219/jada.archive.2004.0052.

Abstract

BACKGROUND

Dentists frequently evaluate patients for oropharyngeal pain that may or may not eventually be related to oral pathology. Two rare neurological disorders that present with severe orofacial pain are trigeminal neuralgia, or TN, and glossopharyngeal neuralgia, or GPN. Both are secondary to cranial nerve compression by arteries and veins at the point at which the nerves exit the pons and brainstem.

RESULTS

The authors present the results for two series of patients treated for TN and GPN. Significant success can be seen after intracranial microvascular decompression for both disorders, with low complication rates. Short- and long-term outcomes depend on proper patient selection.

CLINICAL IMPLICATIONS

It is important for practitioners to recognize these syndromes and properly refer patients to a neurosurgeon experienced in treating such disorders. This can help the dentist and patient avoid oral procedures that will not alleviate the painful symptoms.

摘要

背景

牙医经常评估患者的口咽疼痛,这种疼痛最终可能与口腔病理学有关,也可能无关。两种罕见的神经系统疾病会出现严重的口面部疼痛,即三叉神经痛(TN)和舌咽神经痛(GPN)。两者均继发于神经从脑桥和脑干穿出部位受到动脉和静脉对颅神经的压迫。

结果

作者展示了两组接受TN和GPN治疗患者的结果。两种疾病在进行颅内微血管减压术后均取得了显著成功,并发症发生率较低。短期和长期结果取决于正确的患者选择。

临床意义

从业者认识到这些综合征并将患者正确转诊给有治疗此类疾病经验的神经外科医生非常重要。这可以帮助牙医和患者避免无法缓解疼痛症状的口腔手术。

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