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三叉神经疱疹后神经痛:从病理生理学到治疗。

Trigeminal Postherpetic Neuralgia: From Pathophysiology to Treatment.

机构信息

Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

出版信息

Curr Pain Headache Rep. 2024 Apr;28(4):295-306. doi: 10.1007/s11916-023-01209-z. Epub 2024 Jan 23.

Abstract

PURPOSE OF REVIEW

Trigeminal postherpetic neuralgia (TG-PHN) is a neuropathic pain condition complicating herpes zoster (HZ) attributed to the trigeminal nerve. It poses significant challenges due to its persistent and debilitating nature. This review explores the clinical characteristics of TG-PHN, analyzes its pathophysiological underpinnings, and addresses existent and potential therapies.

RECENT FINDINGS

TG-PHN is one of the most common and complex PHN locations. It has distinguishing clinical and pathophysiological characteristics, starting with viral triggered injuries to the trigeminal ganglion (TG) and peripheral tissue and involving the ascending and descending brain modulation pathways. Current therapies include vaccines, oral and topical medications, and interventional approaches, like nerve blocks and neurostimulation. This review covers TG-PHN's clinical and physiological components, treatment options, and potential future targets for improved management. By exploring the complexities of this condition, we aim to contribute to developing more effective and targeted therapies for patients suffering from trigeminal PHN.

摘要

目的综述

三叉神经带状疱疹后神经痛(TG-PHN)是一种神经病理性疼痛疾病,由带状疱疹(HZ)累及三叉神经引起。由于其持续性和使人虚弱的性质,它带来了重大的挑战。本综述探讨了 TG-PHN 的临床特征,分析了其病理生理基础,并讨论了现有的和潜在的治疗方法。

最近的发现

TG-PHN 是最常见和最复杂的 PHN 部位之一。它具有独特的临床和病理生理特征,始于病毒对三叉神经节(TG)和外周组织的触发损伤,涉及上行和下行的脑调制途径。目前的治疗方法包括疫苗、口服和局部药物以及神经阻滞和神经刺激等介入方法。本综述涵盖了 TG-PHN 的临床和生理成分、治疗选择以及潜在的未来管理目标。通过探索这种疾病的复杂性,我们旨在为患有三叉神经 PHN 的患者开发更有效和有针对性的治疗方法做出贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8491/10940365/827a5a91cce5/11916_2023_1209_Fig1_HTML.jpg

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