De Simone Roberto, Ranieri Angelo, Bilo Leonilda, Fiorillo Chiara, Bonavita Vincenzo
Department of Neurological Sciences, University Federico II of Naples, Via Pansini 5, 80131 Naples, Italy.
Neurol Sci. 2008 May;29 Suppl 1:S69-78. doi: 10.1007/s10072-008-0892-7.
Cranial neuralgias are paroxysmal painful disorders of the head characterised by some shared features such as unilaterality of symptoms, transience and recurrence of attacks, superficial and "shock-like" quality of pain and the presence of triggering factors. Although rare, these disorders must be promptly recognised as they harbour a relatively high risk for underlying compressive or inflammatory disease. Nevertheless, misdiagnosis is frequent. Trigeminal and glossopharyngeal neuralgias are sustained in most cases by a neurovascular conflict in the posterior fossa resulting in a hyperexcitability state of the trigeminal circuitry. If the aetiology of trigeminal neuralgia (TN) and other typical neuralgias must be brought back to the peripheral injury, their pathogenesis could involve central allodynic mechanisms, which, in patients with inter-critical pain, also engage the nociceptive neurons at the thalamic-cortical level. Currently available medical treatments for TN and other cranial neuralgias are reviewed.
颅神经痛是头部的发作性疼痛疾病，具有一些共同特征，如症状单侧性、发作短暂且反复、疼痛表浅呈“电击样”性质以及存在触发因素。尽管这些疾病罕见，但必须迅速识别，因为它们存在潜在压迫性或炎性疾病的相对较高风险。然而，误诊很常见。在大多数情况下，三叉神经痛和舌咽神经痛是由后颅窝的神经血管冲突引起的，导致三叉神经回路处于高敏状态。如果三叉神经痛（TN）和其他典型神经痛的病因必须追溯到外周损伤，那么它们的发病机制可能涉及中枢性痛觉过敏机制，在发作间期疼痛的患者中，这种机制还会在丘脑 - 皮质水平激活伤害性神经元。本文综述了目前可用于治疗TN和其他颅神经痛的药物。
