Lang E, Naraghi R, Tanrikulu L, Hastreiter P, Fahlbusch R, Neundörfer B, Tröscher-Weber R
Department of Neurology and Pain Center, University of Erlangen-Nuremberg, D-91054 Erlangen, Germany.
J Neurol Neurosurg Psychiatry. 2005 Nov;76(11):1506-9. doi: 10.1136/jnnp.2005.066084.
Patients with atypical neuralgia or atypical facial pain have been surgically treated with microvascular decompression (MVD) of the trigeminal root entry zone (TREZ). There are no data regarding the sensitivity and specificity of a vessel-TREZ relationship as a cause of pain in patients with persistent idiopathic facial pain (PIFP) according to the definition given by the International Headache Society (IHS).
The TREZ was visualised by 3D CISS MRI in 12 patients with unilateral PIFP according to the IHS criteria.
The frequency of artery-TREZ, vein-TREZ, or vessel (artery/vein)-TREZ contacts on the symptomatic and asymptomatic sides did not differ significantly. On the symptomatic side, vessel-TREZ contact was found in 58% of patients (sensitivity). On the asymptomatic side, vessel-TREZ contact was absent in 33% of patients (specificity).
On the basis of the low sensitivity and specificity found in the present study, PIFP cannot be attributed to a vessel-TREZ contact, and therefore, pain relief after MVD cannot be expected.
非典型神经痛或非典型面部疼痛患者已接受三叉神经根入区（TREZ）微血管减压术（MVD）治疗。根据国际头痛协会（IHS）给出的定义，关于血管与TREZ关系作为持续性特发性面部疼痛（PIFP）患者疼痛原因的敏感性和特异性尚无数据。
根据IHS标准，对12例单侧PIFP患者采用三维稳态构成干扰序列（CISS）磁共振成像（MRI）观察TREZ。
有症状侧和无症状侧动脉与TREZ、静脉与TREZ或血管（动脉/静脉）与TREZ接触的频率无显著差异。在有症状侧，58%的患者发现血管与TREZ接触（敏感性）。在无症状侧，33%的患者未发现血管与TREZ接触（特异性）。
基于本研究中发现的低敏感性和特异性，PIFP不能归因于血管与TREZ接触，因此，不能期望MVD术后疼痛缓解。
