病理生理学和耐火三神经疼痛的管理
Jennifer I Stern1, Rushna Ali2, Chia-Chun Chiang1
1Department of Neurology, Headache Division, Mayo Clinic, Rochester, MN, USA.
Current neurology and neuroscience reports
|December 12, 2024
概括
耐火性三神经疼痛 (TN) 管理包括探索超越标准治疗的先进选择. 本综述涵盖了当初策略失败时,持续性面部疼痛的较少常见疗法.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 疼痛管理 疼痛管理
背景情况:
- 三神经疼痛 (TN) 是一种使人虚弱的神经病性面部疼痛状况.
- 微血管减压 (MVD) 后的复发是一个重大的临床挑战.
- 对于耐火TN的"盒外"治疗方法的证据有限.
研究的目的:
- 审查耐火性三角神经疼痛 (TN) 的病理生理学和管理.
- 讨论TN复发后微血管减压后的原因.
- 探索难治性TN的先进和替代治疗方案.
主要方法:
- 对目前对耐火TN的理解和管理策略的文献综述.
- 关于二线和三线口服药物的讨论.
- 探索干预程序和神经调节技术的探索.
主要成果:
- 不同的选择包括毒素A,重复MVD,废除手术,神经溶解和神经阻塞.
- 讨论了神经调节 (TMS,外周刺激) 和先进疗法 (DBS,MCS,聚焦超声波thalamotomy).
- 在TN中先进疗法的证据有限,通常基于小型研究和病例报告.
结论:
- 在手术后管理复发性TN是具有挑战性的,需要考虑多种侵入性和最小侵入性选择.
- 对耐火TN的最佳阶段性方法需要进一步研究.
- 多学科的方法对于耐火性三角神经疼痛至关重要.
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