舌咽神经痛:流行病学、危险因素、病理生理学、鉴别诊断及治疗选择

Glossopharyngeal Neuralgia: Epidemiology, Risk factors, Pathophysiology, Differential diagnosis, and Treatment Options.

作者信息

Han Andrew, Montgomery Carver, Zamora Alexandra, Winder Emilie, Kaye Adam, Carroll Caroline, Aquino Alfonso, Kakazu Juyeon, Kaye Alan D

机构信息

School of Medicine Georgetown University School of Medicine.

Louisiana State University Shreveport.

出版信息

Health Psychol Res. 2022 Jun 28;10(5):36042. doi: 10.52965/001c.36042. eCollection 2022.

Abstract

PURPOSE OF REVIEW

This is a comprehensive review of the most recent literature on glossopharyngeal neuralgia (GPN), a relatively rare form of neuropathic facial pain. It covers the epidemiology, risk factors, pathophysiology, and differential diagnosis given that glossopharyngeal neuralgia can often be confused with other facial pain syndromes. Finally, we extensively review recent findings regarding medical or conservative measures, minimally invasive, and surgical options for potentially treating and managing glossopharyngeal neuralgia.

RECENT FINDINGS

An in-depth analysis of the recent literature indicates that glossopharyngeal neuralgia is not only rare but its etiology and pathophysiology are complex and are often secondary to other disease processes. Regardless, current management options are shown to be effective in controlling pain. Conservatively, first-line management of GPN is carbamazepine, but gabapentin and eslicarbazepine acetate are suitable alternatives. In terms of current minimally invasive pain management techniques, pulsed radiofrequency ablation, nerve blocks, or percutaneous radiofrequency thermocoagulation are effective. Finally, surgical management involves microvascular decompression and rhizotomy.

SUMMARY

While there are currently many viable options for addressing glossopharyngeal neuralgia pain ranging from conservative to surgical management, the complex nature of GPN etiology, pathophysiology, and involved anatomical structures prompts further research for more effective ways to treat the disease.

摘要

综述目的

本文全面回顾了关于舌咽神经痛(GPN)的最新文献,舌咽神经痛是一种相对罕见的神经性面部疼痛形式。鉴于舌咽神经痛常与其他面部疼痛综合征相混淆,本文涵盖了其流行病学、危险因素、病理生理学及鉴别诊断。最后,我们广泛回顾了近期有关潜在治疗和管理舌咽神经痛的药物或保守措施、微创及手术选择的研究结果。

近期研究结果

对近期文献的深入分析表明,舌咽神经痛不仅罕见,其病因和病理生理学复杂,且常继发于其他疾病过程。尽管如此,目前的管理方案已证明在控制疼痛方面有效。保守治疗方面,GPN的一线治疗药物是卡马西平,但加巴喷丁和醋酸艾司利卡西平也是合适的替代药物。就目前的微创疼痛管理技术而言,脉冲射频消融、神经阻滞或经皮射频热凝术均有效。最后,手术治疗包括微血管减压术和神经根切断术。

总结

虽然目前有许多可行的方法来解决舌咽神经痛,从保守治疗到手术治疗,但GPN病因、病理生理学及相关解剖结构的复杂性促使人们进一步研究更有效的治疗方法。

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