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[颈椎手法治疗对典型三叉神经痛的影响:一例报告]

[Influence of manual therapy of cervical spine on typical trigeminal neuralgia: a case report].

作者信息

Grgić Vjekoslav

出版信息

Lijec Vjesn. 2010 Jan-Feb;132(1-2):21-4.

Abstract

This article presents the case of a 43-year-old female patient with pain in the cervical spine area and a typical trigeminal neuralgia (TN; French name "tic douloureux") in the receptive field of the second and the third branches of the left trigeminal nerve. The patient came to our medical practice for a manual therapy of the cervical spine as the application of the standard therapy had not given her any pain reduction in the cervical spine area. As the result of the manual therapy of the cervical spine (nonspecific traction mobilization, specific or segmental mobilization, manipulation), not only a significant pain reduction in the cervical spine area occurred but also a complete cessation of TN. Before manual treatment, and in spite of antiepileptic drugs therapy and acupuncture, the patient had suffered from everyday typical TN attacks. The cessation of typical TN after manual therapy of cervical spine suggests a conclusion that the painful stimuli from the cervical spine structures can be manifested not only as atypical facial pain and/or a cervicogenic headache, but also as a typical TN (painful stimuli from the cervical spine structures-->trigeminocervical nuclei-->convergence of the painful stimuli-->referred pain in the receptive field of the trigeminal nerve-->typical or atypical TN and/or cervicogenic headache).

摘要

本文介绍了一名43岁女性患者的病例,该患者颈椎区域疼痛,且在左侧三叉神经第二和第三分支的感觉区域出现典型的三叉神经痛(TN;法语名称为“tic douloureux”)。由于标准治疗未能减轻该患者颈椎区域的疼痛,她前来我们的医疗诊所接受颈椎手法治疗。颈椎手法治疗(非特异性牵引松动、特异性或节段性松动、整复)的结果是,不仅颈椎区域的疼痛显著减轻,而且三叉神经痛完全停止。在手法治疗前,尽管患者接受了抗癫痫药物治疗和针灸治疗,但仍每天遭受典型的三叉神经痛发作。颈椎手法治疗后典型三叉神经痛停止,这表明颈椎结构的疼痛刺激不仅可以表现为非典型面部疼痛和/或颈源性头痛,还可以表现为典型的三叉神经痛(颈椎结构的疼痛刺激→三叉颈核→疼痛刺激汇聚→三叉神经感觉区域的牵涉痛→典型或非典型三叉神经痛和/或颈源性头痛)。

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