Maxwell R E
J Neurosurg. 1982 Oct;57(4):459-66. doi: 10.3171/jns.1982.57.4.0459.
Chronic migrainous neuralgia is not diagnosed as often as the periodic or "cluster" form of Horton's syndrome. The distinguishing features of chronic migrainous neuralgia, compared with the periodic variety, are the frequency and persistence of the attacks of hemicraniofacial pain and the intractability to medical management. Eight male patients ranging in age from 22 to 45 years received prompt, although transient, pain relief by blockade of the Gasserian ganglion on the side of their hemifacial pain with a local anesthetic. Prolonged relief was subsequently achieved by percutaneous radiofrequency trigeminal ganglio-rhizolysis. There were no significant complications from this procedure. Review of the literature indicated that other ablative neurosurgical procedures, such as alcohol injection of the Gasserian ganglion and trigeminal rhizotomy by the subtemporal craniectomy approach, have relieved migrainous neuralgia, but with a greater risk and incidence of complications. The characteristic clinical features of migrainous neuralgia and the medical and surgical approaches to therapy are discussed.
慢性偏头痛性神经痛的诊断频率不如霍顿综合征的周期性或“丛集性”形式高。与周期性类型相比，慢性偏头痛性神经痛的显著特征是半侧颅面部疼痛发作的频率和持续性以及药物治疗的难治性。8名年龄在22至45岁之间的男性患者，通过用局部麻醉剂阻断其半侧面部疼痛一侧的半月神经节，获得了迅速但短暂的疼痛缓解。随后通过经皮射频三叉神经节根切断术实现了长期缓解。该手术没有明显并发症。文献回顾表明，其他消融性神经外科手术，如半月神经节酒精注射和经颞下颅骨切除术入路的三叉神经根切断术，已缓解偏头痛性神经痛，但并发症风险和发生率更高。本文讨论了偏头痛性神经痛的特征性临床特征以及药物和手术治疗方法。
