三叉神经 神经痛

迹象 & 症状

三叉神经痛的症状包括:

• Very 疼痛ful, sharp, electric shock-like facial 疼痛 that usually lasts a few seconds or minutes.
• 疼痛通常只发生在脸的一侧, 通常在眼睛周围, 脸颊和脸部下部.
• 触摸或声音可能会引起疼痛, 或者通过日常活动，比如刷牙, 咀嚼, 喝, 吃, 剃须和轻触面部.

诊断

To confirm the diagnosis of trigeminal neuralgia and exclude other treatable causes of face 疼痛, 我们会对他进行全面的神经系统评估, 包括回顾一下你的疼痛史, 药物, 你过去尝试过的治疗方法. We will discuss your current treatment and review any neuroimaging scans related to your face 疼痛, 所以请带着这些扫描结果去看十大赌博平台排行榜. We will then tailor further evaluations and treatment recommendations based on our findings and your preferences.

治疗

药物治疗总是治疗三叉神经痛的第一线. 病人 who continue to experience 疼痛 despite the best medical management will be evaluated for surgery.

三叉神经痛的医学治疗

The medicines doctors typically prescribe to treat trigeminal neuralgia were originally developed to treat 癫痫. 然而, 这类药物, 所谓的抗惊厥药物, 被发现对治疗神经痛很有效, 包括三叉神经痛, 当采取持续的基础上.

The anti-convulsant drug most commonly prescribed for trigeminal neuralgia is carbamazepine (Tegretol), which can provide at least partial 疼痛 relief for up to 80 to 90 percent of patients. 其他常用于治疗三叉神经痛的抗惊厥药物包括:

• 苯妥英(狄兰汀)
• 加巴喷丁(丁)
• 拉莫三嗪(利)
• 奥卡西平(Trileptal)
• 托吡酯(治)

也可以开肌肉松弛剂巴氯芬, 单独使用或与其他药物联合使用.

副作用

这些药物最常见的副作用是头晕, 睡意, 健忘, 不稳定和恶心. 除了, 随着时间的推移，这些药物并不总是有效的, requiring higher and higher doses or a greater number of 药物 taken together. Some patients experience side effects serious enough to warrant discontinuing the medication.

三叉神经痛的外科治疗

三叉神经 neuralgia surgery is reserved for people who still experience debilitating 疼痛 despite the best attempts to manage their condition with medication. Surgery for trigeminal neuralgia is rarely attempted on patients with non-trigeminal neuralgia face 疼痛 or on atypical trigeminal neuralgia, 由于这些十大赌博靠谱网络平台下的手术成功率要低得多, 在很多情况下, 会使疼痛加重和/或引起额外的医疗问题吗.

微血管减压术

微血管减压(MVD), 也被称为Jannetta程序, 治疗三叉神经痛最常见的外科手术是什么. 在程序中, the surgeon makes a small incision behind the ear and drills a small hole in the skull. 显微镜下显示三叉神经. 在大多数情况下, 有血管，通常是动脉, 但有时静脉压迫三叉神经. By moving this blood vessel away from the nerve and interposing a padding made of Teflon felt, 疼痛几乎总能得到缓解.

而MVD被认为是三叉神经痛最具侵入性的手术, it is also the best procedure for fixing the underlying problem: vascular compression. MVD对三叉神经的损伤最小，并提供, 平均, the longest 疼痛-free periods and the best chance for the patient to be permanently off medication. MVD has a long-term success rate of approximately 80 percent as a stand-alone treatment. 这一过程平均需要住院两到三天, 四到六周后恢复正常的日常活动.

MVD是一项大手术，包括开颅，在颅骨上切一个小洞. Typical surgical risks for any open-skull neurosurgical procedure include infection, 大出血, 脊髓液漏和麻醉风险. 罕见的神经损伤包括听力损伤, 血管损伤(中风)和, 很少, 死亡.

伽玛刀放射外科

伽玛刀 三叉神经痛的微创手术选择是吗. 事实上，从技术上讲，这根本不是手术. 伽玛刀是一种精确的, 控制辐射束到达头骨内的目标, 包括大脑和相关神经. 用于治疗三叉神经痛, the radiation beams are aimed at the trigeminal nerve where it enters the brainstem.

伽玛刀治疗并不针对三叉神经痛的根本原因, 反而会损害三叉神经来阻止疼痛信号的传递. The procedure requires little or no anesthesia, and is performed on an outpatient basis.

This procedure provides significant 疼痛 control or reduction in approximately 80 percent or more of patients, 但反应通常比其他治疗慢. 病人 usually begin to respond to the treatment within four to 12 weeks post-treatment, 但有些患者需要长达6至12个月的时间才能完全缓解. Most patients remain on full doses of their trigeminal neuralgia medication for at least three to six months after treatment. Typically, we do not start to taper the patient's 药物 until 疼痛 relief has been achieved.

副作用可能包括面部刺痛或麻木, 20%到30%的病人都有这种症状. If they do occur, these 症状 do not typically appear until six to 24 months following treatment. The resulting numbness (sometimes referred to as paresthesias or dysesthesias) can range in intensity from mild to severe and may affect the entire side of the face.

射频损伤

射频损伤, 也叫射频根治术, 对于严重疼痛的高危患者，这是一个好的选择吗, such as patients with an additional illness that would make an open surgical procedure too dangerous. 这也是一个很好的选择，为患者 多发性硬化(MS)，其三叉神经痛往往不是由血管压迫引起的.

比如伽玛刀治疗, 射频损伤不能治疗三叉神经痛的根本原因, 反而会损害三叉神经来阻止疼痛信号的传递. 在程序中, an electrode inserted through the cheek is used to heat the nerve and cause selective damage to stop 疼痛 signals from traveling to the brain.

这种治疗方法可以立即缓解90%的患者的疼痛. 然而, 它确实比其他手术更容易引起面部麻木, and 50 percent of patients will experience 疼痛 recurrence within five years post-surgery. 如有必要，可重复此过程.

射频损伤的侵入性较小, 比MVD风险更小，住院时间也更短. 然而, 它也会带来更大的术后轻微到严重麻木的风险, 哪一种可能是永久性的, 此外疼痛复发率较高. This procedure also carries the rare general surgical risks of infection and 大出血, 以及严重的神经损伤, 角膜麻木, 麻醉麻醉与颅内出血.