Trigeminal neuralgia

Trigeminal neuralgia (TN) ke lefu la methapo. E baka bohloko ba ho hlaba kapa ba motlakase joalo ka motlakase likarolong tsa sefahleho.

Bohloko ba TN bo tsoa methapong ea trigeminal. Mothapo ona o na le maikutlo a ho ama le bohloko ho tloha sefahlehong, mahlong, lisoneng le molomong ho ea bokong.

Trigeminal neuralgia e ka bakoa ke:

• Multiple sclerosis (MS) kapa maloetse a mang a senyang tšireletso e sireletsang myelin ea methapo
• Khatello ea methapo ea trigeminal e tsoang sejaneng sa mali se ruruhileng kapa hlahala
• Ho lematsa methapo e meraro, joalo ka ho tsoa ts'ebetsong ho ea sefahlehong kapa ho buuoa ka molomo kapa ka sinus

Hangata, ha ho na lebaka le tobileng le fumanoang. TN hangata e ama batho ba baholo ho feta lilemo tse 50, empa e ka ba teng ka lilemo tsohle. Basali ba ameha khafetsa ho feta banna. Ha TN e ama batho ba ka tlase ho lilemo tse 40, hangata e bakoa ke MS kapa hlahala.

Matšoao a ka kenyelletsa efe kapa efe ea tse latelang:

• Mahlaba a bohloko haholo, a bohale a kang a motlakase a atisang ho nka metsotsoana e mengata ho isa tlase ho metsotso e 2, empa a ka fetoha khafetsa.
• Bohloko hangata bo lehlakoreng le leng la sefahleho, hangata ho potoloha leihlo, lerama le karolo e tlase ea sefahleho.
• Hangata ha ho na tahlehelo ea maikutlo kapa motsamao oa karolo e amehileng ea sefahleho.
• Bohloko bo ka bakoa ke ho ama kapa melumo.

Litlhaselo tse bohloko tsa trigeminal neuralgia li ka bakoa ke mesebetsi e tloaelehileng, ea letsatsi le letsatsi, joalo ka:

• Ho bua
• Ho bososela
• Ho hlatsoa meno
• Ho hlafuna
• Ho noa
• Ho ja
• Ho ba le mocheso o chesang kapa o batang
• Ho ama sefahleho
• Ho kuta litelu
• Moea
• Ho etsa makeup

Lehlakore le letona la sefahleho le ameha haholo. Maemong a mang, TN e ea itsamaela.

Hangata tlhahlobo ea methapo ea boko le methapo e tloaelehile. Liteko tse etsoang ho batla sesosa li ka kenyelletsa:

• Palo e felletseng ea mali
• Sekhahla sa sedimentation sa Erythrocyte (ESR)
• MRI ea hlooho
• MRA (angiography) ea boko
• Ho hlahlojoa mahlo (ho thibela lefu la intraocular)
  
• Tlhatlhobo ea hlooho ea CT (ea sa khoneng ho etsa MRI)
  
• Teko ea Trigeminal reflex (maemong a sa tloaelehang)

Ngaka ea hau ea mantlha ea tlhokomelo, ngaka ea methapo, kapa setsebi sa bohloko e kanna ea ameha tlhokomelong ea hau.

Meriana e meng ka linako tse ling e thusa ho fokotsa bohloko le sekhahla sa litlhaselo. Meriana ena e kenyelletsa:

• Meriana e thibelang ho ts'oaroa, joalo ka carbamazepine
• Phomolo ea mesifa, joalo ka baclofen
• Tricyclic ho imeloa kelellong

Phomolo ea bohloko ba nako e khuts'oane e hlaha ka ho buuoa, empa e amahanngoa le kotsi ea mathata. Phekolo e le 'ngoe e bitsoa microvascular decompression (MVD) kapa ts'ebetso ea Jannetta. Nakong ea opereishene, ho beoa lintho tse kang seponche lipakeng tsa methapo le methapo ea mali e hatellang mothapong.

Trigeminal nerve block (ente) e nang le `` anesthetic '' ea lehae le steroid ke khetho e ntle ea kalafo ea ho kokobetsa bohloko kapele ha o emetse hore meriana e sebetse.

Mekhoa e meng e kenyelletsa ho senya kapa ho seha likarolo tsa methapo ea methapo ea methapo. Mekhoa e sebelisitsoeng e kenyelletsa:

• Ho tlosoa ha mahlaseli a mahlaseli (ho sebelisa mocheso o phahameng haholo)
• Ho entoa glycerol kapa joala
• Microcompression ea balune
• Radiosurgery (e sebelisa matla a maholo)

Haeba hlahala e le sesosa sa TN, ho etsoa opereishene ho e tlosa.

Hore na o sebetsa hantle hakae ho latela sesosa sa bothata. Haeba ho se lefu le bakang bothata, kalafo e ka u fa phomolo.

Ho batho ba bang, bohloko bo ba teng khafetsa le ho ba matla.

Mathata a ka kenyelletsa:

• Litla-morao tsa meriana e sebelisetsoang ho phekola TN
• Mathata a bakoang ke lits'ebetso, joalo ka tahlehelo ea maikutlo sebakeng se phekotsoeng
• Ho theola boima ba 'mele ka ho se je ho qoba ho baka bohloko
• Ho qoba batho ba bang haeba ho bua ho baka bohloko
• Ho tepella maikutlo, ho ipolaea
• Matšoenyeho a phahameng nakong ea litlhaselo tse matla

Ikopanye le mofani oa tlhokomelo ea bophelo haeba u na le matšoao a TN, kapa matšoao a hau a TN a mpefala.

Tic douloureux; Cranial neuralgia; Bohloko ba sefahleho - trigeminal; Sefahleho neuralgia; Neuralgia ea boraro; Bohloko bo sa foleng - trigeminal; Microvascular decompression - trigeminal

• Sisteme ea methapo e bohareng le methapo ea methapo

Bendtsen L, Zakrzewska JM, Heinskou TB, le al. Tsoelo-pele ea ho hlahlojoa, tlhophiso, pathophysiology, le taolo ea trigeminal neuralgia. Lancet Neurol. 2019; 19 (9): 784-796. PMID: 32822636 phatlalalitsoeng.ncbi.nlm.nih.gov/32822636/.

Gonzales TS. Bohloko ba sefahleho le maloetse a neuromuscular. Ka: Neville BW, Damm DD, Allen CM, Chi AC, bahlophisi. Molomo le Maxillofacial Pathology. La 4 ed. St Louis, MO: Elsevier; 2016: khaolo ea 18.

Stettler BA. Mathata a boko le boko ba methapo. Ka: Marako RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Likhopolo le Tloaelo ea Kliniki. La 9th. Philadelphia, PA: Elsevier; 2018: khaolo ea 95.

Waldman SD. Trigeminal neuralgia. Ka: Waldman SD, e hlophisitsoeng. Atlas of Common Pain Syndromes. La 4 ed. Philadelphia, PA: Elsevier; 2020: khaolo ea 10.