Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Headache. 2019 Mar;59(3):358-370. doi: 10.1111/head.13469. Epub 2019 Jan 11.
Structural damage or demyelization of the sphenopalatine ganglion may cause sphenopalatine neuralgia (SN). The current International Classification of Headache Disorders, third edition (ICHD-3) regards SN as a phenotype of cluster headache. Whether SN is an independent neuralgia entity has been debated for years.
This article presents a case series of SN, a review of all published cases, and a pooled data analysis of the identified cases.
Seven patients were identified, with a median age at symptom onset of 59 years. Six cases were secondary to structural lesions surrounding the ipsilateral sphenopalatine ganglion, and all of them experienced significant clinical improvements after removing the primary causes. In the seventh patient, no evidence of underlying disease was found. The literature review showed that SN affected patients spanning a wide range of ages and both sexes. The clinical characteristics of SN might mimic cluster headache with the exception of cluster pattern and treatment response to oxygen. The typical duration of pain episodes in SN was several hours to several days; and in some cases, pain was persistent. Sixty-seven percent (59/88) of patients with SN had structural lesions around the sphenopalatine ganglion.
SN could possibly be regarded as a different clinical entity from cluster headache. Based on our patients and literature review, SN can be categorized as idiopathic SN and secondary SN. Craniofacial structural lesions should be highly rating and taken into account when SN is suspected.
翼腭神经节的结构损伤或脱髓鞘可能导致翼腭神经痛（SN）。目前的《国际头痛疾病分类》第三版（ICHD-3）将 SN 视为丛集性头痛的一种表型。SN 是否是一种独立的神经痛实体多年来一直存在争议。
本文介绍了一组 SN 病例，回顾了所有已发表的病例，并对已确定的病例进行了汇总数据分析。
共发现 7 例患者，症状发作的中位年龄为 59 岁。6 例为同侧翼腭神经节周围结构病变所致，所有患者在去除主要病因后均有明显的临床改善。第 7 例患者未发现潜在疾病。文献回顾显示，SN 影响的患者年龄跨度较大，且男女均可患病。SN 的临床特征可能与丛集性头痛相似，除了丛集模式和对氧气的治疗反应。SN 疼痛发作的典型持续时间为数小时至数天；在某些情况下，疼痛持续存在。67%（59/88）的 SN 患者有翼腭神经节周围结构病变。
SN 可能被视为不同于丛集性头痛的一种临床实体。基于我们的患者和文献回顾，SN 可分为特发性 SN 和继发性 SN。颅面结构病变应高度评价，并在怀疑 SN 时考虑在内。
