Department of Neurology School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
Int J Environ Res Public Health. 2020 Sep 25;17(19):7012. doi: 10.3390/ijerph17197012.
Trigeminal neuralgia (TN), the most common form of severe facial pain, may be confused with an ill-defined persistent idiopathic facial pain (PIFP). Facial pain is reviewed and a detailed discussion of TN and PIFP is presented. A possible cause for PIFP is proposed. (1) Methods: Databases were searched for articles related to facial pain, TN, and PIFP. Relevant articles were selected, and all systematic reviews and meta-analyses were included. (2) Discussion: The lifetime prevalence for TN is approximately 0.3% and for PIFP approximately 0.03%. TN is 15-20 times more common in persons with multiple sclerosis. Most cases of TN are caused by neurovascular compression, but a significant number are secondary to inflammation, tumor or trauma. The cause of PIFP remains unknown. Well-established TN treatment protocols include pharmacotherapy, neurotoxin denervation, peripheral nerve ablation, focused radiation, and microvascular decompression, with high rates of relief and varying degrees of adverse outcomes. No such protocols exist for PIFP. (3) Conclusion: PIFP may be confused with TN, but treatment possibilities differ greatly. Head and neck muscle myofascial pain syndrome is suggested as a possible cause of PIFP, a consideration that could open new approaches to treatment.
三叉神经痛（TN）是最常见的严重面部疼痛形式，可能与定义不明确的持续性特发性面部疼痛（PIFP）相混淆。本文回顾了面部疼痛，并对 TN 和 PIFP 进行了详细讨论。提出了 PIFP 的可能原因。(1) 方法：在与面部疼痛、TN 和 PIFP 相关的数据库中搜索文章。选择相关文章，并纳入所有系统评价和荟萃分析。(2) 讨论：TN 的终生患病率约为 0.3%，PIFP 约为 0.03%。多发性硬化症患者中 TN 的发病率高 15-20 倍。大多数 TN 是由神经血管压迫引起的，但相当一部分是炎症、肿瘤或创伤引起的。PIFP 的病因仍不清楚。经过充分验证的 TN 治疗方案包括药物治疗、神经毒素去神经支配、周围神经消融、聚焦辐射和微血管减压，缓解率高，但不良反应程度不同。PIFP 尚无此类方案。(3) 结论：PIFP 可能与 TN 混淆，但治疗可能性有很大差异。头颈部肌肉肌筋膜疼痛综合征被认为是 PIFP 的可能原因，这一考虑可能为治疗开辟新途径。
