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复发性三叉神经痛:病例系列及文献综述

Recurrent Trigeminal Neuralgia: A Case Series and a Review of the Literature.

作者信息

Vardhan Harsha, S Sushmitha, N Nagammai, K Saraswathi

机构信息

Oral Medicine and Radiology, Meenakshi Ammal Dental College, Chennai, IND.

Faculty of Dentistry, Oral Medicine and Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.

出版信息

Cureus. 2022 Feb 23;14(2):e22548. doi: 10.7759/cureus.22548. eCollection 2022 Feb.

DOI:10.7759/cureus.22548
PMID:35345688
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8956785/
Abstract

Trigeminal neuralgia is a peripheral neuropathy characterized by intermittent episodes of severe facial pain originating in the sensory nucleus of the trigeminal nerve. The most commonly involved area is the mandibular division with a higher prevalence on the right side. Advances in the field of MRI have played an important role in its diagnosis, especially in presurgical assessment, to probe into any secondary causes of nerve compression and/or neurovascular conflict. The condition is primarily managed medically, although many patients may require surgical or radiotherapeutic intervention. A recurrence rate ranging from 6 to 41% has been postulated. Reasons for recurrence are mainly attributed to improper operative techniques, dislocation of the Teflon implant, or granuloma formation. MRI serves as a powerful tool in the segmental evaluation of the trigeminal nerve. A proper diagnosis with a structured treatment protocol is critical for managing such cases of trigeminal neuralgia. In this report, we present a series of two cases of recurrent trigeminal neuralgia.

摘要

三叉神经痛是一种周围神经病变,其特征为源自三叉神经感觉核的严重面部疼痛间歇性发作。最常受累的区域是下颌支,右侧患病率更高。MRI领域的进展在其诊断中发挥了重要作用,尤其是在术前评估中,以探究神经受压和/或神经血管冲突的任何继发性原因。尽管许多患者可能需要手术或放射治疗干预,但该疾病主要通过药物治疗。据推测,复发率在6%至41%之间。复发原因主要归因于手术技术不当、聚四氟乙烯植入物移位或肉芽肿形成。MRI是三叉神经节段性评估的有力工具。采用结构化治疗方案进行正确诊断对于管理此类三叉神经痛病例至关重要。在本报告中,我们展示了一系列两例复发性三叉神经痛病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91ec/8956785/10a530895786/cureus-0014-00000022548-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91ec/8956785/0b2b20724595/cureus-0014-00000022548-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91ec/8956785/10a530895786/cureus-0014-00000022548-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91ec/8956785/0b2b20724595/cureus-0014-00000022548-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91ec/8956785/10a530895786/cureus-0014-00000022548-i02.jpg

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Neurosurg Focus. 2020 Oct;49(4):E23. doi: 10.3171/2020.7.FOCUS20446.
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Multiple Recurrences of Trigeminal Neuralgia Caused by Deformation of the Trigeminal Nerve.三叉神经变形导致三叉神经痛的多次复发
Cureus. 2019 Dec 20;11(12):e6433. doi: 10.7759/cureus.6433.
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A systematic review of rescue analgesic strategies in acute exacerbations of primary trigeminal neuralgia.
原发性三叉神经痛急性发作时的解救性镇痛策略的系统评价
Br J Anaesth. 2019 Aug;123(2):e385-e396. doi: 10.1016/j.bja.2019.05.026. Epub 2019 Jun 15.
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Repeat microvascular decompression for patients with persistent or recurrent trigeminal neuralgia: Prognostic factors and long-term outcomes.三叉神经痛持续或复发患者的重复微血管减压术:预后因素和长期结果
Medicine (Baltimore). 2019 May;98(18):e15167. doi: 10.1097/MD.0000000000015167.
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Effects of Microvascular Decompression Plus Longitudinal Nerve Sectioning on Recurrent Trigeminal Neuralgia and Investigations of Postoperative Recurrence Causes.微血管减压术联合纵行神经切断术治疗复发性三叉神经痛的效果及术后复发原因探讨
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