三叉神经痛的临床治疗进展

Clinical Treatment Progress of Trigeminal Neuralgia

三叉神经痛是一种常见的面部疼痛性疾病,目前对其病因的认识并不明确。普遍认为压迫可导致三叉神经痛,致病原因包括血管因素和非血管因素,其次创伤也可导致三叉神经痛,常见于口腔外科手术后。三叉神经痛的治疗方法较多,首选药物治疗,包括全身用药和局部用药,药物治疗初期效果明显,但很难治愈三叉神经痛,而且需要长期服药,副作用较大,当药物治疗无效或者患者难以耐受其副作用时,可采用外科疗法进行辅助治疗。三叉神经痛的外科疗法主要包括无创的微血管减压术及有创的射频热凝术、球囊压迫术和甘油毁损术。近年来采用放射外科对三叉神经痛进行治疗,取得了确切效果。此外,还有一些关于其他治疗方法的文献报道,均有一定效果。本文对三叉神经痛病因的认识及临床治疗进展作一回顾性综述。

Trigeminal neuralgia （TN）is a severe facial pain syndrome, but the etiology oftrigeminal neuralgia remains unclear. It is commonly considered that vascular and non-vascular oppression are main factors, and trauma is another factor of TN, which is the result of surgical interventions performed by dentists. There are quite a number of treatment options for TN. Medical treatment is preferred, including systemic administration and local application. Although the initial effect is obvious, it is still difficult for medical treatment to cure TN. Furthermore, long-term use of medications could lead to many adverse effects. When medical treatment fails or severe adverse effects cannot be tolerated by patients, surgical treatment becomes necessary, including non-destructive microvascular decompression and destructive percutaneous techniques consisting of radiofrequency thermocoagulation, balloon compression, and glycerol rhizotomy. Recently, radiosurgery were used to treat trigeminal neuralgia and achieved the satisfactory effects. In addition, some other treatment methods which got effects were reported in different literatures. In this summary, we reviewed the etiology and clinical treatment progress of TN.