Ramirez H, Martinez C, Oliva J, Montini C
Odontol Chil. 1989 Dec;37(2):264-9.
The efficacy of drug treatment on 119 patients with trigeminal neuralgia is reported in the present paper. Among them, 112 were idiopathic trigeminal neuralgias while only 7 cases were secondary trigeminal neuralgias. All patients were treated with drugs at different stages of the evolution of the neuralgia. Carbamazepine was used on all patients. 12.6% was treated with imipramine (tricyclic antidepressive drug), 4 patients received amphetamines due to psychiatric emergencies, 4 patients were treated with phenytoin before this study and three patients received baclofen during short periods of follow-up. Drug therapy was the only treatment method in 51 patients. In 43 patients it was combined with peripheral surgical treatments including injections of alcohol and neurectomies. 16.8% of the patients were treated with drugs and acupuncture; the results of this experience will be reported in a future paper. Only 4.2% (5 patients) underwent neurosurgical treatment: one ponto cerebellar angle tumour, one electrocoagulation of the gasserian ganglion through the stereotaxic method and three cases of microvascular decompression of the trigeminal root. Clinical, pharmacological and neurophysiological aspects of trigeminal neuralgia pharmacotherapy are discussed.
本文报道了药物治疗119例三叉神经痛患者的疗效。其中,112例为原发性三叉神经痛,仅7例为继发性三叉神经痛。所有患者在神经痛发展的不同阶段均接受了药物治疗。所有患者均使用了卡马西平。12.6%的患者使用了丙咪嗪(三环类抗抑郁药),4例患者因精神紧急情况接受了苯丙胺治疗,4例患者在本研究之前使用了苯妥英钠,3例患者在短期随访期间接受了巴氯芬治疗。51例患者仅采用药物治疗。43例患者采用了包括酒精注射和神经切除术在内的外周手术治疗联合药物治疗。16.8%的患者采用了药物和针灸治疗;该治疗经验的结果将在未来的论文中报道。仅4.2%(5例患者)接受了神经外科治疗:1例桥小脑角肿瘤,1例通过立体定向方法对半月神经节进行电凝,3例三叉神经根微血管减压术。本文还讨论了三叉神经痛药物治疗的临床、药理学和神经生理学方面。