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[带状疱疹后神经痛的神经外科治疗]

[Neurosurgical treatment of postherpetic neuralgia].

作者信息

Isagulyan E D, Semenov D E, Tomskiy A A

机构信息

Burdenko Neurosurgery Institute, Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2024;124(2):154-157. doi: 10.17116/jnevro2024124021154.

Abstract

Postherpetic neuralgia is a chronic and debilitating condition that can occur following an episode of herpes zoster (shingles). It is characterized by severe, persistent pain in the area where the shingles rash occurred. While various treatment approaches exist, including medications and non-invasive therapies, some cases of postherpetic neuralgia may require neurosurgical intervention. Neurosurgical treatment options for postherpetic neuralgia aim to alleviate the pain by targeting the affected nerves or neural pathways. One common approach is spinal cord stimulation (SCS). In SCS, electrodes are implanted along the spinal cord, and electrical impulses are delivered to interfere with the transmission of pain signals. This technique can modulate pain perception and significantly reduce the intensity and frequency of postherpetic neuralgia symptoms. Neurosurgical treatment of postherpetic neuralgia is typically considered when conservative measures have failed to provide sufficient relief. However, it is crucial for patients to undergo a comprehensive evaluation and consultation with a neurosurgeon to determine the most appropriate treatment approach based on their specific condition and medical history. The risks, benefits, and potential outcomes of neurosurgical interventions should be carefully discussed between the patient and their healthcare provider to make an informed decision.

摘要

带状疱疹后神经痛是一种慢性且使人衰弱的病症,可在带状疱疹(俗称“蛇串疮”)发作后出现。其特征是在带状疱疹皮疹出现的区域有严重、持续的疼痛。虽然存在各种治疗方法,包括药物治疗和非侵入性疗法,但某些带状疱疹后神经痛病例可能需要神经外科干预。针对带状疱疹后神经痛的神经外科治疗方案旨在通过针对受影响的神经或神经通路来减轻疼痛。一种常见的方法是脊髓刺激(SCS)。在脊髓刺激中,电极沿着脊髓植入,然后传递电脉冲以干扰疼痛信号的传递。该技术可以调节疼痛感知,并显著降低带状疱疹后神经痛症状的强度和频率。当保守措施未能提供足够的缓解时,通常会考虑对带状疱疹后神经痛进行神经外科治疗。然而,患者接受全面评估并与神经外科医生进行咨询,以根据其具体病情和病史确定最合适的治疗方法至关重要。患者与其医疗服务提供者之间应仔细讨论神经外科干预的风险、益处和潜在结果,以便做出明智的决定。

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