Chicoine Nicole H, Yaacoub Alan P, Jea Andrew, Raskin Jeffrey S
School of Medicine, Marian University College of Osteopathic Medicine, Indianapolis, Indiana, USA.
Section of Pediatric Neurosurgery, Riley Hospital for Children, Department of Neurological Surgery, Goodman Campbell Brain and Spine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
World Neurosurg. 2019 Jan;121:217-221. doi: 10.1016/j.wneu.2018.10.074. Epub 2018 Oct 19.
Trigeminal neuralgia (TN) is a well-recognized facial pain syndrome. Discrete forms with disparate pain symptoms include classic and atypical. However, atypical facial pain includes neuralgiform pain along a spectrum. Most cases of TN are diagnosed in the adult population. Case reports and series of children have presented TN as a similar entity, with treatment similar to that for adults. We reviewed the pertinent data and present 2 pediatric TN cases successfully treated with microvascular decompression (MVD).
Two pediatric patients (age 12 and 15 years) with TN refractory to previous medical therapy were identified. Both patients were deemed appropriate surgical candidates and underwent MVD to manage their TN. TN compression was arterial in both cases and involved portions of the anterior inferior cerebellar artery. Patient 1 was pain free 6 months after the procedure. Patient 2 was pain free immediately after the procedure and had been weaned off preoperative symptomatic management at the latest follow-up visit. The most recent follow-up examination was 12 and 8 months for patients 1 and 2, respectively, with both experiencing continued freedom from pain.
Few studies have reported on the effectiveness of MVD in the pediatric population for the management of TN. The supporting data and our 2 cases have demonstrated that MVD is effective for pediatric patients to treat their TN. Furthermore, the side effects appear to be minimal, with excellent pain relief after MVD in this patient population.
三叉神经痛（TN）是一种公认的面部疼痛综合征。具有不同疼痛症状的离散形式包括典型和非典型。然而，非典型面部疼痛包括一系列神经样疼痛。大多数TN病例在成人中被诊断出来。儿童病例报告和系列研究表明TN在儿童中是一种类似的疾病，其治疗方法与成人相似。我们回顾了相关数据，并介绍了2例成功接受微血管减压术（MVD）治疗的儿童TN病例。
确定了2例先前药物治疗无效的儿童TN患者（年龄分别为12岁和15岁）。两名患者均被认为是合适的手术候选人，并接受了MVD来治疗他们的TN。两例患者的TN压迫均为动脉性，累及小脑下前动脉的部分。患者1术后6个月无疼痛。患者2术后立即无疼痛，在最近一次随访时已停用术前的对症治疗。患者1和患者2的最近一次随访检查分别为12个月和8个月，两人均持续无疼痛。
很少有研究报道MVD在儿童人群中治疗TN的有效性。支持性数据和我们的2例病例表明，MVD对儿童患者治疗TN有效。此外，副作用似乎最小，该患者群体MVD术后疼痛缓解良好。
