Lam Jordan L W, Sankar Tejas, Sekula Raymond F, Senatus Patrick B, Patil Parag G
Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.
Department of Neurosurgery, University of Alberta, Edmonton, AB, Canada.
Curr Pain Headache Rep. 2025 Jan 28;29(1):37. doi: 10.1007/s11916-024-01316-5.
Trigeminal neuralgia (TN) is a highly heterogeneous condition with a wide choice of successful treatment options. However, differences between subtypes are poorly understood and it remains unknown which patients will respond to different treatments. This review aims to summarize the current state of the TN field and explore the problem of predicting surgical outcomes.
Attempts have been made to standardize classification, outcome reporting, and treatment guidelines. Identification of risk factors for poor surgical treatment outcomes has led to the development of prognostic scoring systems to predict outcomes and guide management. Advances in imaging techniques including diffusion tensor imaging show promise in better understanding the underlying pathophysiology and predicting surgical outcomes. Progress is hampered by lack of understanding of the pathophysiology in TN and differences between disease subtypes. Further work needs to be done to create accurate prediction tools for widespread use, including use of advanced imaging and computing tools, multicenter collaboration, and prospective validation.
三叉神经痛（TN）是一种高度异质性疾病，有多种成功的治疗选择。然而，各亚型之间的差异了解甚少，哪些患者会对不同治疗产生反应仍不清楚。本综述旨在总结TN领域的现状，并探讨预测手术结果的问题。
已尝试对分类、结果报告和治疗指南进行标准化。对手术治疗效果不佳的危险因素的识别促使了预后评分系统的开发，以预测结果并指导管理。包括扩散张量成像在内的成像技术进展有望更好地理解潜在病理生理学并预测手术结果。对TN病理生理学的理解不足以及疾病亚型之间的差异阻碍了进展。需要进一步开展工作，以创建广泛使用的准确预测工具，包括使用先进的成像和计算工具、多中心协作以及前瞻性验证。
