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三叉神经痛(TN):诊断和治疗方法的描述性文献分析。

Trigeminal neuralgia (TN): A descriptive literature analysis on the diagnosis and management modalities.

机构信息

Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, AP-HM, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France.

Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, AP-HM, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France; IFSSTAR, LBA, UMR-T 24, Aix Marseille université, 13344 Marseille, France.

出版信息

J Stomatol Oral Maxillofac Surg. 2017 Sep;118(4):251-254. doi: 10.1016/j.jormas.2017.06.010. Epub 2017 Jun 23.

Abstract

OBJECTIVE

The primary objective of this review is to explore the different aspects of the diagnosis and management of Trigeminal neuralgia (TN). We look at the role of radiological imaging in the work-up of this condition, and based on the findings in the literature, we report data on the medical and surgical management of TN.

MATERIALS AND METHODS

A literature review was conducted using PubMed and Cochrane search engines in order to explore the data available on the diagnosis and management of TN. Clinical features and various treatment modalities were analyzed by the authors. The identified studies were evaluated and data was reported on the different aspects of the condition in order to provide an evidence-based update on the topic.

DISCUSSION

The diagnosis of TN is based on the patient's clinical history and radiological imaging. The commonest cause of TN is a micro-vascular compression by a looping blood vessel. Radiological evaluation is critical in the work-up of the disorder and in order to eliminate other possible causes. Management of the disorder can be medical or surgical, with micro-vascular decompression having the highest remission rate.

CONCLUSION

Patients with TN present paroxysmal pain attacks in the territories innervated by the trigeminal nerve. Diagnostic investigations must allow precise anatomical evaluation of the CPA, and MR imaging is the gold-standard radiological investigation for this purpose. Management of TN can be medical or surgical, with micro-vascular decompression having the highest success rate.

摘要

目的

本综述的主要目的是探讨三叉神经痛(TN)的诊断和治疗的各个方面。我们研究了影像学在该疾病诊断中的作用,并根据文献中的发现,报告了关于 TN 的医学和手术治疗的数据。

材料和方法

通过 PubMed 和 Cochrane 搜索引擎进行文献回顾,以探讨有关 TN 诊断和治疗的现有数据。作者对临床特征和各种治疗方式进行了分析。对确定的研究进行了评估,并报告了该疾病不同方面的数据,以便就该主题提供循证更新。

讨论

TN 的诊断基于患者的临床病史和影像学。TN 最常见的原因是血管环对三叉神经根的微血管压迫。影像学评估对该疾病的诊断至关重要,有助于排除其他可能的病因。该疾病的治疗可以是药物治疗或手术治疗,微血管减压术的缓解率最高。

结论

TN 患者表现为三叉神经支配区域的阵发性疼痛发作。诊断性检查必须允许对桥小脑角进行精确的解剖学评估,磁共振成像(MRI)是为此目的的金标准影像学检查。TN 的治疗可以是药物治疗或手术治疗,微血管减压术的成功率最高。

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