三叉神经痛二医讲课.pptVIP

* It affects lifestyle as it can be triggered by common activities such as eating, talking, shaving and brushing teeth. Wind, high pitched sounds, loud noises such as concerts or crowds, chewing, and talking can aggravate the condition in many patients. The attacks are said by those affected to feel like stabbing electric shocks, burning, pressing, crushing, exploding or shooting pain that becomes intractable. Trigeminal neuralgia affects the trigeminal nerve, one of the largest nerves in the head. The trigeminal nerve sends impulses of touch, pain, pressure, and temperature to the brain from the face, jaw, gums, forehead, and around the eyes. 原发性 诱因不明确 继发性——各种损伤 带状疱疹 肿瘤压迫 肿瘤治疗 短时间压迫外周神经不痛，最多只持续数分钟 持续压迫可以导致局部脱髓鞘，轴突电位连续性没有了 慢性神经束缚导致原发性脱髓鞘，结果导致轴突进行性退变 In a patient experiencing trigeminal neuralgia, the neurological exam is typically normal.? Again, the diagnosis of trigeminal neuralgia rests mainly in the history of the patient, and is recognized by the physician 大部分是动脉压迫，也有部分是静脉 大部分是动脉压迫，也有部分是静脉 Gamma Knife is an excellent treatment option for trigeminal neuralgia.? The success rate is roughly 80%-85%, and the risk is minimal.? The improvement in pain is not immediate, but can take from several days, up to three months after treatment.? This is a half day treatment.? The patient enters the Gamma Knife department, and a frame is placed on the head.? A detailed MRI scan of the brain is done, focusing upon the trigeminal nerve.? A treatment plan is then formulated by the neurosurgeon, radiation oncologist and physicist.? The treatment is then delivered, and the patient is discharged home.? Treatment options for trigeminal neuralgia range from medication to rhizotomy, to open microvascular decompression of the trigeminal nerve leaving the brainstem, to Gamma Knife radiosurgery. Gamma Knife has an 80% to 85% chance of having a good to excellent result.? The likelihood of complications using the Gamma Knife is low.? With Gamma Knife, the patient undergoes the pr