三叉神经痛的最新进展

Jaisan Islam, Elina Kc, Young Seok Park
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引用次数: 1

摘要

三叉神经痛(TN)是一种影响三叉神经的长期疾病,是一种使人衰弱的神经性疼痛。尽管TN的潜在发病机制尚存争议,但由于血管直接压迫或继发于多发性硬化症或中风等其他疾病,沿三叉神经髓磷脂的损失被认为是主要原因。阵发性散发性疼痛,单侧起病,是TN的主要症状。药物、手术和辅助技术是目前改变与TN相关的神经回路的治疗选择。然而,抗癫痫和三环抗抑郁药物被认为是一线治疗方法,对于使用至少三种药物均未获得治疗效果、出现难以忍受的副作用或症状无法缓解的患者,可能需要手术治疗。刺激大脑区域是一种新兴的标签外技术,有可能缓解TN的疼痛,但足够的数据和对动物和人类的更广泛的研究尚未发表。更具体地说,便利的诊断技术和负担得起的治疗方式已成为关键需求,以减少TN造成的心理和社会经济损失。
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Recent update on trigeminal neuralgia
Trigeminal neuralgia (TN), a long-term disorder affecting the trigeminal nerve, is a form of debilitating neuropathic pain. Although the underlying pathogenesis of TN is debatable, loss of myelin along the trigeminal nerve due to direct compression from a blood vessel or secondary to other conditions such as multiple sclerosis or stroke is thought to be the principal cause. Paroxysmal sporadic pain, with unilateral onset, is the main phenomenon of TN. TN is typically diagnosed clinically. Medications, surgery, and complementary techniques are among the current therapy options for altering the neural circuits associated with TN. Nevertheless, anti-epileptic and tricyclic antidepressant medications are recognized as first-line treatments, and surgical treatment may be required for patients who have not obtained a therapeutic effect with at least three medications, have experienced intolerable side effects, or have symptoms that are not resolving. Stimulation of brain regions is an emerging off-label technique that has the potential to offer pain relief from TN, but sufficient data and more extensive studies on both animals and humans are yet to be published. More specifically, convenient diagnostic techniques and affordable treatment modalities for TN have become crucial needs in order to reduce the psychological and socio-economical losses caused by TN.
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