三叉神经 神经痛
Overview
三叉神经 neuralgia is a nerve disorder that causes sudden, brief episodes of severe stabbing or electric shock-like 疼痛 in parts of the face.
The 疼痛 comes from the trigeminal nerve, the major sensory nerve of the face. This nerve is responsible for sending impulses of touch, 疼痛, pressure and temperature to the brain from the face, 下巴, 牙龈和舌头. 三叉神经痛通常是由动脉或静脉压迫三叉神经引起的, but it can also occur with no apparent cause. It is often misdiagnosed as a dental or 下巴 problem.
This condition can be extremely distressing for patients. 一旦诊断正确, 有几种药物和手术治疗方案可以减少或缓解这种使人衰弱的疼痛.
我们治疗三叉神经痛的方法
UCSF provides highly specialized, world-class care for trigeminal neuralgia. 治疗计划从控制神经疼痛的药物开始，但如果药物被证明无效，可能包括手术. 我们还提供非侵入性伽玛刀放射手术和一种称为射频病变的技术. Both are used to cause targeted damage to the trigeminal nerve, 停止疼痛信号的传递.
For patients whose severe facial 疼痛 has not been diagnosed, 我们的团队在确定疼痛是否由三叉神经痛或其他疾病引起方面提供专业知识.
奖 & 识别
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是全国顶尖的十大赌博平台排行榜之一
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加州最好，排名第一. 神经病学全国排名第二 & 神经外科
迹象 & 症状
三叉神经痛的症状包括:
- 非常痛苦的、尖锐的、类似电击的面部疼痛，通常持续几秒钟或几分钟.
- Pain usually occurs on one side of the face only, 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, or by everyday activities such as brushing teeth, 咀嚼, 喝, 吃, 剃须和轻触面部.
诊断
目的:明确三叉神经痛的诊断，排除其他可治疗的面部疼痛原因, we will perform a thorough neurologic evaluation, 包括回顾一下你的疼痛史, 药物, treatments and procedures you have tried in the past. 我们将讨论您目前的治疗方法并检查与您面部疼痛相关的神经成像扫描, so please bring these scans with you to your appointment. 然后我们会根据我们的发现和你的喜好来制定进一步的评估和治疗建议.
治疗
Medication is always the first line of treatment for trigeminal neuralgia. 尽管采取了最好的医疗措施，但仍然感到疼痛的患者将接受手术评估.
Medical treatments for trigeminal neuralgia
十大赌博平台排行榜通常开的治疗三叉神经痛的药物最初是用来治疗癫痫的. 然而, 这类药物, 所谓的抗惊厥药物, has been found to be quite effective in tr吃 nerve 疼痛, 包括三叉神经痛, 当采取持续的基础上.
治疗三叉神经痛最常用的抗惊厥药物是卡马西平(替格妥)。, 哪一种方法可以至少缓解80%到90%的患者的部分疼痛. Other anti-convulsants prescribed frequently for trigeminal neuralgia include:
- 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)
The muscle relaxant baclofen (Lioresal) may also be prescribed, either alone or in combination with other drugs.
副作用
The most common side effects from these medicines are dizziness, 睡意, 健忘, 不稳定和恶心. 除了, these drugs do not always remain effective over time, 需要越来越大的剂量或同时服用更多的药物. 有些病人会出现严重的副作用，需要停药.
Surgical treatments for trigeminal neuralgia
三叉神经痛手术是为那些尽管用药物治疗了最好的尝试，但仍然感到虚弱疼痛的人保留的. 手术治疗三叉神经痛的患者很少尝试非三叉神经痛，面部疼痛或非典型三叉神经痛, since operations for these conditions have much lower success rates and, 在很多情况下, can make the 疼痛 worse and/or cause additional medical problems.
微血管减压术
微血管减压(MVD), 也被称为Jannetta程序, is the most common surgical procedure for tr吃 trigeminal neuralgia. 在程序中, 外科十大赌博平台排行榜在耳后做一个小切口，在颅骨上钻一个小洞. Using microscopic visualization, the trigeminal nerve is exposed. 在大多数情况下, there is a blood vessel — typically an artery, but sometimes a vein — compressing the trigeminal nerve. 通过将血管从神经上移开并插入由特氟龙毡制成的填充物, 疼痛几乎总能得到缓解.
While MVD is considered to be the most invasive surgery for trigeminal neuralgia, 这也是解决潜在问题的最佳方法:血管压迫. MVD also causes the least damage to the trigeminal nerve and provides, 平均, 最长的无痛期和患者永久停药的最佳机会. MVD作为一种独立治疗的长期成功率约为80%. The procedure requires an average hospital stay of two to three days, and four to six weeks to return to normal daily activities.
MVD is a major surgery, and includes craniotomy, cutting a small hole in the skull. 任何开颅神经外科手术的典型风险包括感染, 大出血, spinal fluid leakage and risks of anesthesia. Rare neurological injury can include damage to hearing, 血管损伤(中风)和, 很少, 死亡.
伽玛刀放射外科
伽玛刀 is the least invasive surgical option for trigeminal neuralgia. In fact, it is technically not surgery at all. The 伽玛刀 is a device that delivers precise, controlled beams of radiation to targets inside the skull, 包括大脑和相关神经. 用于治疗三叉神经痛, 放射束瞄准进入脑干的三叉神经.
伽玛刀 treatment does not target the root cause of trigeminal neuralgia, but instead damages the trigeminal nerve to stop the transmission of 疼痛 signals. 该手术需要很少或不需要麻醉，在门诊进行.
该手术对大约80%或更多的患者提供了显著的疼痛控制或减轻, but response is usually slower than for other treatments. 患者通常在治疗后4至12周内开始对治疗产生反应, but some patients require as much as six to 12 months for the full response. 大多数患者在治疗后至少三到六个月仍坚持服用足剂量的三叉神经痛药物. 通常情况下，我们不会开始逐渐减少病人的药物治疗，直到疼痛得到缓解.
副作用 may include tingling or numbness in the face, seen in up to 20 to 30 percent of patients. 如果确实发生，这些症状通常在治疗后6至24个月才出现. 由此产生的麻木(有时被称为感觉异常或感觉不良)的强度从轻微到严重不等，并可能影响整个面部.
射频损伤
射频损伤, 也叫射频根治术, is a good option for severe 疼痛 in high-risk patients, 比如患有其他疾病的病人，这种疾病会使开放式手术过于危险. It is also a good option for patients with 多发性硬化(MS), whose trigeminal neuralgia often is not caused by vascular compression.
比如伽玛刀治疗, radiofrequency lesioning does not treat the root cause of trigeminal neuralgia, but instead damages the trigeminal nerve to stop the transmission of 疼痛 signals. 在程序中, 通过脸颊插入一个电极来加热神经，造成选择性损伤，以阻止疼痛信号传递到大脑.
The treatment provides immediate 疼痛 relief in up to 90 percent of patients. 然而, it does cause more facial numbness than the other procedures, 50%的患者会在手术后五年内经历疼痛复发. If necessary, the procedure can be repeated.
射频损伤的侵入性较小, less risky and requires less time in the hospital than MVD. 然而, it also carries a greater risk of minor to severe post-surgical numbness, 哪一种可能是永久性的, in addition to the higher rate of 疼痛 recurrence. 这种手术也有感染和大出血等罕见的普通手术风险, 以及严重的神经损伤, 角膜麻木, anesthesia dolorosa and intracranial hemorrhage.
加州大学旧金山分校健康 medical specialists have reviewed this information. 它仅用于教育目的，并不打算取代您的十大赌博平台排行榜或其他医疗保健提供者的建议. 我们鼓励您与您的供应商讨论您可能遇到的任何问题或疑虑.
