Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl

PL EN


Preferences help
enabled [disable] Abstract
Number of results
2016 | 16 | 2 | 85-91

Article title

Neuralgia trójdzielna

Authors

Content

Title variants

EN
Trigeminal neuralgia

Languages of publication

PL EN

Abstracts

PL
Neuralgia trójdzielna należy do najcięższych bólów w obrębie twarzy. Choć została opisana przez wielu badaczy, dzisiaj nazywa się ją chorobą Fothergilla, co upamiętnia przedstawienie neuralgii trójdzielnej przez tego uczonego w 1773 roku. Zachorowalność jest oceniana na 2–5/100 tys. osób, częściej chorują kobiety. Nerw trójdzielny to nerw czuciowo-ruchowy, który wspólnie z nerwami językowo-gardłowym i błędnym, nerwami podpotylicznym, potylicznymi mniejszymi i większymi oraz nerwem usznym wielkim unerwia skórę głowy. Włókna przewodzące bodźce bólowe przez zwój nerwu trójdzielnego kończą się w jądrze rdzeniowym, skąd przez jądra wzgórza docierają do kory czuciowej, układu limbicznego i wyspy. Przyczyn bólu w neuralgii upatruje się w uszkodzeniu włókien czuciowych grubych Aβ i powstałych ogniskach ektopowego pobudzenia – przenoszonego na uszkodzone strukturalnie włókna cienkie Aδ i C w obrębie połączeń zwanych efapsami. Neuralgię trójdzielną dzieli się na klasyczną i objawową. Obie postacie charakteryzują się napadami bólu o typie rażenia prądem elektrycznym, trwającymi od kilku sekund do dwóch minut. Ból najczęściej dotyczy obszaru unerwionego przez drugą i trzecią gałąź nerwu trójdzielnego, czyli nerw szczękowy i żuchwowy. Cechą charakterystyczną są strefy spustowe, których drażnienie przez bodźce niebólowe wywołuje napad neuralgii. Leczenie neuralgii trójdzielnej obejmuje postępowanie zachowawcze i chirurgiczne. W leczeniu zachowawczym złotym standardem jest stosowanie karbamazepiny lub okskarbazepiny. W przypadku niepowodzenia można włączyć baklofen, lamotryginę albo inny lek używany w leczeniu padaczki. Spośród metod chirurgicznych najczęściej stosuje się: odbarczenie konfliktu naczyniowo-nerwowego, ucisk zwoju troistego balonem, przezskórną blokadę zwoju Gassera glicerolem, przecięcie włókien zazwojowych nerwu trójdzielnego falami radiowymi i stereotaktyczną radiochirurgię (gamma knife).
EN
Trigeminal neuralgia is one of the most severe facial pains. Although it has been broadly described by many researchers, it is referred to as Fothergill’s disease to commemorate the researcher who gave the first full and accurate description of trigeminal neuralgia in 1773. Trigeminal neuralgia incidence ranges from 2 to 5 cases per 100,000 people, with women being affected more often than men. The trigeminal nerve has a sensory and motor function, and along with the glossopharyngeal nerve, the vagus nerve, the suboccipital nerve, the greater and lesser occipital nerves and the great auricular nerve innervate the skin of the head. Fibres that convey pain stimuli through the trigeminal ganglion terminate in the spinal nucleus, from where, passing through the nuclei of the thalamus, they reach the sensory cortex, the limbic system and the insular cortex. The reasons behind painful sensation in neuralgia may be the damage of the thick Aβ nerve fibres and the appearance of focuses of ectopic excitation which is then transferred to the damaged structural thin Aδ and C nerve fibres in neural connections referred to as ephapses. There are two types of trigeminal neuralgia: classic and symptomatic. Both types are characterised by a sudden, electric shock-like pain that lasts from a couple of seconds to two minutes. More often than not, the pain affects the area innervated by the second and the third branch of the trigeminal nerve, namely the maxillary and the mandibular nerve. Trigger zones are characteristic for this condition, and – when irritated by non-pain stimuli – they cause an attack of neuralgia. The management of trigeminal neuralgia involves surgical and conservative treatment. The golden standard for the conservative treatment is to use carbamazepine or oxcarbazepine. Should the aforementioned treatment fail, baclofen, lamotrigine or other anticonvulsant drug used in the treatment of epilepsy may be introduced. The following are the most frequently used surgical methods of treatment: decompression of the neurovascular conflict, the use of trigeminal ganglion balloon compression, the use of percutaneous glycerol block of the Gasserian ganglion, cutting postganglionic nerve fibres with radiofrequency and stereotactic radiosurgery (gamma knife).

Discipline

Year

Volume

16

Issue

2

Pages

85-91

Physical description

Contributors

  • Klinika Neurologii, II Wydział Lekarski, Warszawski Uniwersytet Medyczny, Warszawa, Polska. Kierownik Kliniki: prof. dr hab. n. med. Jan Kochanowski

References

  • Ang JW, Khanna A, Walcott BP et al.: Central nervous system lymphoma presenting as trigeminal neuralgia: a diagnostic challenge. J Clin Neurosci 2015; 22: 1188–1190.
  • Argoff CE: Review of current guidelines on the care of postherpetic neuralgia. Postgrad Med 2011; 123: 134–142.
  • Arishima H, Kawajiri S, Arai H at al.: Percutaneous glycerol rhizotomy for trigeminal neuralgia using a single-plane, flat panel detector angiography system: technical note. Neurol Med Chir (Tokyo) 2016; 56: 257–263.
  • Attal N, Cruccu G, Baron R at al.: EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol 2010: 17: 1113–e88.
  • Besta R, Shankar U, Kumar A et al.: MRI 3D CISS – a novel imaging modality in diagnosing trigeminal neuralgia – a review. J Clin Diagn Res 2016; 10: ZE01–ZE03.
  • Beydoun A: Safety and efficacy of oxcarbazepine: results of randomized, double-blind trials. Pharmacotherapy 2000; 20: 152S–158S.
  • Cheng JS, Lim DA, Chang EF et al.: A review of percutneus treatments for trigeminal neuralgia. Neurosurgery 2014; 10 Suppl 1: 25–33.
  • Cheshire WP Jr: Defining the role for gabapentin in the treatment of trigeminal neuralgia: a retrospective study. J Pain 2002; 3: 137–142.
  • Cohen-Gadol AA: Microvascular decompression surgery for trigeminal neuralgia and hemifacial spasm: naunces of the technique based on experiences with 100 patients and review of the literature. Clin Neurol Neurosurg 2011; 113: 844–853.
  • Collet C, Haen P, Laversanne S et al.: Trigeminal neuralgia: a new therapy? Med Hypotheses 2013; 81: 1088–1089.
  • Cruccu G, Truini A: Refractory trigeminal neuralgia. Non-surgical treatment options. CNS Drugs 2013; 27: 91–96.
  • Cruccu G, Gronseth G, Alksne J et al.; American Academy of Neurology Society; European Federation of Neurological Society: AANEFNS guidelines on trigeminal neuralgia management. Eur J Neurol 2008; 15: 1013–1028.
  • Devor M, Amir R, Rappaport ZH: Pathophysiology of trigeminal neuralgia: the ignition hypothesis. Clin J Pain 2002; 18: 4–13.
  • Domingues RB, Kuster GW, Aquino CC: Treatment of trigeminal neuralgia with low doses of topiramate. Arq Neuropsiquiatr 2007; 65: 792–794.
  • Dzierżanowski J, Słoniewski P, Jeliński R et al.: Wyniki leczenia 64 chorych z nerwobólem nerwu trójdzielnego metodą przezskórnej termoablacji zwoju Gassera. Ann Acad Med Gedan 2010; 40: 11–17.
  • Fromm GH, Terrence CF, Chattha AS et al.: Baclofen in trigeminal neuralgia: its effect on the spinal trigeminal nucleus: a pilot study. Arch Neurol 1980; 37: 768–771.
  • Gorgulho AA, De Salles AA: Impact of radiosurgery on the surgical treatment of trigeminal neuralgia. Surg Neurol 2006; 66: 350–356.
  • Hall GC, Carroll D, Parry D et al.: Epidemiology and treatment of neuropathic pain: the UK primary care perspective. Pain 2006; 122: 156–162.
  • Hingwala D, Chatterjee S, Kesavadas C et al.: Applications of 3D CISS sequence for problem solving in neuroimaging. Indian J Radiol Imaging 2011; 21: 90–97.
  • Huibin Q, Jianxing L, Guangyu H et al.: The treatment of first division idiopathic trigeminal neuralgia with radiofrequency thermocoagulation of the peripheral branches compared to conventional radiofrequency. J Clin Neurosci 2009; 16: 1425–1429.
  • Jannetta PJ: Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg 1967; 26 Suppl: 159–162.
  • Jha AN: Trigeminal neuralgia: therapeutic options. Neurol India 2015; 63: 837–840.
  • Jorns TP, Johnston JM, Zakrzewska JM: Pilot study to evaluate the efficacy and tolerability of levetiracetam (Keppra) in treatment of patients with trigeminal neuralgia. Eur J Neurol 2009; 16: 740–744.
  • Koopman JS, Dieleman JP, Huygen FJ et al.: Incidence of facial pain in the general population. Pain 2009; 147: 122–127.
  • Krafft RM: Trigeminal neuralgia. Am Fam Physican 2008; 77: 1291–1296.
  • Kugelberg E, Lindblom U: The mechanism of the pain in trigeminal neuralgia. J Neurol Neurosurg Psychiatry 1959; 22: 36–43.
  • Leclercq D, Thiebaut JB, Héran F: Trigeminal neuralgia. Diagn Interv Imaging 2013; 94: 993–1001.
  • Li F, Ma Y, Zou J et al.: Endovascular treatment of rare vascular complications of percutaneous balloon compression for trigeminal neuralgia. Turk Neurosurg 2016; 26: 215–218.
  • Lopez BC, Hamlyn PJ, Zakrzewska JM: Systematic review of ablative neurosurgical techniques for the treatment of trigeminal neuralgia. Neurosurgery 2004; 54: 973–983.
  • Nalamachu S, Morley-Forster P: Diagnosing and managing postherpetic neuralgia. Drugs Aging 2012; 29: 863–869.
  • Oomens MAEM, Forouzanfar T: Pharmaceutical management of trigeminal neuralgia in the elderly. Drugs Aging 2015; 32: 717–726.
  • Raaphorst J, Vanneste J: Numb cheek syndrome as the first manifestation of anti-Hu paraneoplastic neuronopathy. J Neurol 2006; 253: 664–665.
  • Rappaport ZH, Devor M: Trigeminal neuralgia: the role of self-sustaining discharge in the trigeminal ganglion. Pain 1994; 56: 127–138.
  • Régis J, Tuleasca C, Resseguier N et al.: Long-term safety and efficacy of Gamma Knife surgery in classical trigeminal neuralgia: a 497-patient historical cohort study. J Neurosurg 2016a; 124: 1079–1087.
  • Régis J, Tuleasca C, Resseguier N et al.: The very long-term outcome of radiosurgery for classical trigeminal neuralgia. Stereotact Funct Neurosurg 2016b; 94: 24–32.
  • Rustagi A, Roychoudhury A, Bhutia O et al.: Lamotrigine versus pregabalin in the management of refractory trigeminal neuralgia: a randomized open label crossover trial. J Maxillofac Oral Surg 2014; 13: 409–418.
  • Rutkowski M, Zielińska U, Kaczmarczyk R et al.: Chirurgiczne leczenie neuralgii nerwu trójdzielnego. Neurologia Praktyczna 2012; 4: 5–13.
  • Sheehan J, Pan HC, Stroila M et al.: Gamma knife surgery for trigeminal neuralgia: outcomes and prognostic factors. J Neurosurg 2005; 102: 434–441.
  • Shetter AG, Zabramski JM, Speiser BL: Microvascular decompression after gamma knife surgery for trigeminal neuralgia: intraoperative findings and treatment outcomes. J Neurosurg 2005; 102 Suppl: 259–261.
  • Udupi BP, Chouhan RS, Dash HH et al.: Comparative evaluation of percutaneous retrogasserian glycerol rhizolysis and radiofrequency thermocoagulation techniques in the management of trigeminal neuralgia. Neurosurgery 2012; 70: 407–412.
  • Wang QP, Bai M: Topiramate versus carbamazepine for the treatment of classical trigeminal neuralgia: a meta-analysis. CNS Drugs 2011; 25: 847–857.
  • Wu CJ, Lian YJ, Zheng YK et al.: Botulinum toxin type A for the treatment of trigeminal neuralgia: results from a randomized, doubleblind, placebo-controlled trial. Cephalalgia 2012; 32: 443–450.
  • Zakrzewska JM: Diagnosis and differential diagnosis of trigeminal neuralgia. Clin J Pain 2002; 18: 14–21.
  • Zakrzewska JM: Medical management of trigeminal neuropathic pains. Expert Opin Pharmacother 2010; 11: 1239–1254.
  • Zakrzewska JM, McMillan R: Trigeminal neuralgia: the diagnosis and management of this excruciating and poorly understood facial pain. Postgrad Med J 2011; 87: 410–416.
  • Zakrzewska JM, Chaudhry Z, Nurmikko TJ et al.: Lamotrigine (Lamictal) in refractory trigeminal neuralgia: results from a double-blind placebo controlled crossover trial. Pain 1997; 73: 223–230.

Document Type

review

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.psjd-0b57b7f0-868e-4c6f-a8ac-42d6c2e3ef4b
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.