Ruscheweyh Ruth, Gierthmühlen Janne, Hedderich Dennis M, Goßrau Gudrun, Leis Stefan
Neurologische Klinik und Poliklinik, LMU Klinikum, LMU München, Marchioninistr. 15, 81377, München, Deutschland.
Interdisziplinäres Zentrum für Schmerz- und Palliativmedizin, Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland.
Schmerz. 2024 Aug;38(4):283-292. doi: 10.1007/s00482-024-00810-4. Epub 2024 Apr 30.
Trigeminal neuralgia is characterized by severe, lightning-like attacks of pain, which are mandatory for the diagnosis. The pain typically occurs on one side and is often triggered by simply touching the face, chewing or talking. In acute exacerbations, this can also hinder food and fluid intake, resulting in a life-threatening clinical picture. A distinction is made between classical, secondary and idiopathic trigeminal neuralgia. For the diagnosis of trigeminal neuralgia, the medical history and imaging procedures are key for classification. The only active substances approved for the treatment of trigeminal neuralgia in Germany are carbamazepine and phenytoin, which is why off-label drugs often need to be used if there is no or insufficient effect or inacceptable side effects. Cooperation between research and clinical practice to improve the care of affected patients is therefore essential.
三叉神经痛的特点是出现严重的、闪电样疼痛发作,这是诊断该病的必备条件。疼痛通常发生在一侧,常常仅通过触摸面部、咀嚼或说话就会引发。在急性发作期,这还会妨碍食物和液体摄入,从而导致危及生命的临床状况。三叉神经痛分为典型性、继发性和特发性三叉神经痛。对于三叉神经痛的诊断,病史和影像学检查是进行分类的关键。在德国,唯一被批准用于治疗三叉神经痛的活性物质是卡马西平和苯妥英钠,这就是为什么在没有效果或效果不佳或出现不可接受的副作用时,常常需要使用未按药品说明书用药的药物。因此,研究与临床实践之间开展合作以改善对患者的护理至关重要。