Feller L, Khammissa R A G, Fourie J, Bouckaert M, Lemmer J
Department of Periodontology and Oral Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Department of Maxillofacial and Oral Surgery, Sefako Makgatho University, Pretoria, South Africa.
Pain Res Treat. 2017;2017:1681765. doi: 10.1155/2017/1681765. Epub 2017 Dec 5.
Postherpetic neuralgia (PHN) is an unpredictable complication of varicella zoster virus- (VZV-) induced herpes zoster (HZ) which often occurs in elderly and immunocompromised persons and which can induce psychosocial dysfunction and can negatively impact on quality of life. Preventive options for PHN include vaccination of high-risk persons against HZ, early use of antiviral agents, and robust management of pain during the early stage of acute herpes zoster. If it does occur, PHN may persist for months or even years after resolution of the HZ mucocutaneous eruptions, and treatment is often only partially effective. Classical trigeminal neuralgia is a severe orofacial neuropathic pain condition characterized by unilateral, brief but recurrent, lancinating paroxysmal pain confined to the distribution of one or more of the branches of the trigeminal nerve. It may be idiopathic or causally associated with vascular compression of the trigeminal nerve root. The anticonvulsive agents, carbamazepine or oxcarbazepine, constitute the first-line treatment. Microvascular decompression or ablative procedures should be considered when pharmacotherapy is ineffective or intolerable. The aim of this short review is briefly to discuss the etiopathogenesis, clinical features, and treatment of PHN and classical trigeminal neuralgia.
带状疱疹后神经痛(PHN)是水痘-带状疱疹病毒(VZV)引起的带状疱疹(HZ)的一种不可预测的并发症,常见于老年人和免疫功能低下者,可导致心理社会功能障碍,并对生活质量产生负面影响。PHN的预防措施包括对高危人群接种HZ疫苗、早期使用抗病毒药物以及在急性带状疱疹早期进行积极的疼痛管理。如果发生PHN,在HZ皮肤黏膜疹消退后可能会持续数月甚至数年,治疗往往仅部分有效。经典三叉神经痛是一种严重的口腔面部神经性疼痛疾病,其特征为单侧、短暂但反复发作的、局限于三叉神经一个或多个分支分布区域的刀割样阵发性疼痛。它可能是特发性的,也可能与三叉神经根的血管压迫有因果关系。抗惊厥药物卡马西平或奥卡西平是一线治疗药物。当药物治疗无效或无法耐受时,应考虑微血管减压或毁损性手术。本简短综述的目的是简要讨论PHN和经典三叉神经痛的病因发病机制、临床特征及治疗方法。