Moreau Nathan, Peirs Cédric, Dallel Radhouane, Boucher Yves
Laboratoire de neurobiologie orofaciale, EA 7543, Université Paris Cité, Paris, France - Hôpital Bretonneau, Service de médecine bucco-dentaire, AP-HP, Paris, France.
Université Clermont Auvergne, CHU Clermont-Ferrand, Inserm, Neuro-Dol, Clermont-Ferrand, France.
Med Sci (Paris). 2024 Jan;40(1):64-71. doi: 10.1051/medsci/2023197. Epub 2024 Feb 1.
Head pain and notably orofacial pain differs from spinal pain on pathophysiological, clinical, therapeutic and prognostic levels. Its high prevalence, important impact on quality of life and significant socio-economical burden justify specific study of such type of pain. Among them, neuropathic orofacial pain resulting from disease or trauma of the trigeminal nervous system is among the most difficult types of pain to diagnose and to treat. Deciphering of underlying peripheral and central mechanisms has allowed numerous conceptual, clinical and therapeutic advances, notably the role of neural and non neural cell types, such as glia, immunocytes, vascular endothelial cells or the role of trigeminal sensory complex neural circuitry reconfiguration in the development of post-traumatic trigeminal neuropathic pain. Cellular interactions within the trigeminal ganglion, allowing a better understanding of several painful dental, ocular or cephalalgic comorbidities, are also described.
头痛，尤其是口面部疼痛，在病理生理、临床、治疗和预后层面上与脊柱疼痛有所不同。其高患病率、对生活质量的重大影响以及巨大的社会经济负担，使得对这类疼痛进行专门研究具有合理性。其中，由三叉神经系统疾病或创伤引起的神经性口面部疼痛是最难诊断和治疗的疼痛类型之一。对潜在外周和中枢机制的解读带来了众多概念、临床和治疗方面的进展，尤其是神经和非神经细胞类型（如神经胶质细胞、免疫细胞、血管内皮细胞）的作用，以及创伤后三叉神经神经性疼痛发展过程中三叉神经感觉复合神经回路重构的作用。文中还描述了三叉神经节内细胞间的相互作用，这有助于更好地理解几种疼痛性牙科、眼科或头痛合并症。
