原发性三叉神经痛的治疗研究进展

Research progress in the treatment of primary trigeminal neuralgia

原发性三叉神经痛(primary trigeminal neuralgia,PTN)是临床上导致头面部疼痛的常见原因之一,其病因及发病机制尚无明确定论,治疗方式虽较多,但缺乏持久、有效的治疗手段。药物治疗为PTN首选治疗方法,但长期疗效欠佳。对于药物治疗无效或难以耐受药物不良反应者,可选择手术治疗,包括微血管减压术、三叉神经感觉根部分切断术、经皮三叉神经半月节手术、三叉神经周围支手术及神经电刺激等。对于药物治疗无效且无法耐受手术或手术治疗无效者,也可选择立体定向放射治疗,如伽马刀和射波刀等。现就PTN治疗进展作简要综述,以期为临床提供参考。

Primary trigeminal neuralgia(PTN)is one of the common causes of head and facial pain in clinical practice.The etiology and pathogenesis of PTN have not been clearly defined.Although there are many treatment methods for PTN,but there is a lack of durable and effective treatment.Drug therapy is the first option of PTN,but the long-term efficacy is poor.For the patients who fail to respond to drug therapy or can not tolerate the side effects of drugs,surgery is another option,including microvascular decompression,partial trigeminal rhizotomy,percutaneous rhizotomy on the Gasserian ganglion,peripheral branch surgery of the trigeminal nerve,and electrical nerve stimulation.For patients who fail to respond to medical treatment and can not tolerate surgery,stereotactic radiosurgery can also be selected,for example,gamma knife and cyberknife.This article reviewed the treatment progress on PTN,in order to provide clinical reference for clinical practice.