山东大学耳鼻喉眼学报 ›› 2021, Vol. 35 ›› Issue (4): 115-122.doi: 10.6040/j.issn.1673-3770.0.2020.354
徐菲菲1,吴昊2
XU Feifei1,WU Hao2
摘要: 三叉神经痛是最为常见的颅面部疼痛,发病机制尚未完全清楚,常表现为其一个或多个分支中的突然、严重、短暂、尖锐性和复发性疼痛。针对目前各家提出的不同的分类方法、多种发病机制如中枢性假说、神经受压迫学说、炎症反应学说、生物共振假说、离子通道改变学说以及临床多学科参与的治疗手段进展作一综述,为三叉神经病理性疼痛的个性化治疗提供参考。
中图分类号:
[1] Jones MR, Urits I, Ehrhardt KP, et al. A comprehensive review of trigeminal neuralgia[J]. Curr Pain Headache Rep, 2019, 23(10): 74. doi:10.1007/s11916-019-0810-0. [2] 张恺. 三叉神经痛诊断标准探讨及病因、治疗研究进展[J]. 国际神经病学神经外科学杂志, 2018, 45(4): 434-437. doi:10.16636/j.cnki.jinn.2018.04.025. [3] Cruccu G, Finnerup NB, Jensen TS, et al. Trigeminal neuralgia: New classification and diagnostic grading for practice and research[J]. Neurology, 2016, 87(2): 220-228. doi:10.1212/WNL.0000000000002840. [4] 中华医学会神经外科学分会功能神经外科学组,中国医师协会神经外科医师分会功能神经外科专家委员会,上海交通大学颅神经疾病诊治中心.三叉神经痛诊疗中国专家共识[J].中华外科杂志,2015,53(9):657-664. doi:10.3760/cma.j.issn.0529-5815.2015.09.005. [5] 刘清军. 《三叉神经痛诊疗中国专家共识》解读[J]. 中国现代神经疾病杂志, 2018, 18(9): 643-646. doi:10.3969/j.issn.1672-6731.2018.09.003. LIU Qingjun. Interpretation of “Chinese expert consensus on diagnosis and treatment of trigeminal neuralgia”[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2018, 18(9): 643-646. doi:10.3969/j.issn.1672-6731.2018.09.003. [6] Kerr FW, Miller RH. The pathology of trigeminal neuralgia. Electron microscopic studies[J]. Arch Neurol, 1966, 15(3): 308-319. doi:10.1001/archneur.1966.00470150086014. [7] Cheshire WP Jr. Trigeminal neuralgia: Diagnosis and treatment[J]. Curr Neurol Neurosci Rep, 2005, 5(2): 79-85. doi:10.1007/s11910-005-0003-6. [8] 丁丽华, 于生元. 实验性三叉神经痛研究进展[J]. 中国疼痛医学杂志, 2004, 10(4): 231-233. doi:10.3969/j.issn.1006-9852.2004.04.016. [9] 王红润. 不同抗癫痫药物对三叉神经痛的干预效果分析[J]. 慢性病学杂志, 2016, 17(7): 814-815, 818. doi:10.16440/j.cnki.1674-8166.2016.07.033. [10] 赵光明, 陈克敏, 柴维敏, 等. 三叉神经痛患者与健康志愿者丘脑1H-MRS的比较[J]. 放射学实践, 2008, 23(3): 250-253. doi:10.3969/j.issn.1000-0313.2008.03.006. ZHAO Guangming, CHEN Kemin, CHAI Weimin, et al. Comparison of 1H MR spectroscopic findings of thalamus in trigeminal neuralgia patients and healthy volunteers[J]. Radiologic Practice, 2008, 23(3): 250-253. doi:10.3969/j.issn.1000-0313.2008.03.006. [11] Dandy WE. Concerning the cause of trigeminal neuralgia[J]. Am J Surg, 1934, 24(2): 447-455. doi:10.1016/S0002-9610(34)90403-7. [12] Sarsam Z, Garcia-Fiñana M, Nurmikko TJ, et al. The long-term outcome of microvascular decompression for trigeminal neuralgia[J]. Br J Neurosurg, 2010, 24(1): 18-25. doi:10.3109/02688690903370289. [13] Devor M, Amir R, Rappaport ZH. Pathophysiology of trigeminal neuralgia: the ignition hypothesis[J]. Clin J Pain, 2002, 18(1): 4-13. doi:10.1097/00002508-200201000-00002. [14] 张毅, 贺学农, 苏海, 等.伽玛刀治疗原发性三叉神经痛 45 例疗效分析[J]. 第三军医大学学报, 2012, 34(14): 1476-1477 [15] Kerr FW. Pathology of trigeminal neuralgia: light and electron microscopic observations[J]. J Neurosurg, 1967, 26(1): 151-156. doi:10.3171/jns.1967.26.1part2.0151. [16] 赵可, 徐兆水, 唐林卡, 等. 老年三叉神经痛298例病因研究[J]. 中国中西医结合耳鼻咽喉科杂志, 2007, 15(5): 360-362. doi:10.3969/j.issn.1007-4856.2007.05.014. [17] Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis[J]. Brain, 2001, 124(Pt 12): 2347-2360. doi:10.1093/brain/124.12.2347. [18] Donahue JH, Ornan DA, Mukherjee S. Imaging of vascular compression syndromes[J]. Radiol Clin North Am, 2017, 55(1): 123-138. doi:10.1016/j.rcl.2016.08.001. [19] Chen GQ, Wang XS, Wang L, et al. Arterial compression of nerve is the primary cause of trigeminal neuralgia[J]. Neurol Sci, 2014, 35(1): 61-66. doi:10.1007/s10072-013-1518-2. [20] Sindou M, Leston J, Decullier E, et al. Microvascular decompression for primary trigeminal neuralgia: long-term effectiveness and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular conflicts who underwent pure decompression[J]. J Neurosurg, 2007, 107(6): 1144-1153. doi:10.3171/jns-07/12/1144. [21] Brinzeu A, Dumot C, Sindou M. Role of the petrous ridge and angulation of the trigeminal nerve in the pathogenesis of trigeminal neuralgia, with implications for microvascular decompression[J]. Acta Neurochir, 2018, 160(5): 971-976. doi:10.1007/s00701-018-3468-1. [22] Sicard A. Bernard pierson 1925: 1978[J]. Arch Anat Cytol Pathol, 1978, 26(2): 79-80. [23] Liang L, Diao YL, Xu QY, et al. Transcranial segment of the trigeminal nerve: macro-/microscopic anatomical study using sheet plastination[J]. Acta Neurochir(Wien), 2014, 156(3): 605-612. doi:10.1007/s00701-013-1920-9. [24] Uçeyler N, Rogausch JP, Toyka KV, et al. Differential expression of cytokines in painful and painless neuropathies[J]. Neurology, 2007, 69(1): 42-49. doi:10.1212/01.wnl.0000265062.92340.a5. [25] Lis K, Grygorowicz T, Cudna A, et al. Inhibition of TNF reduces mechanical orofacial hyperalgesia induced by Complete Freund's Adjuvant by a TRPV1-dependent mechanism in mice[J]. Pharmacol Rep, 2017, 69(6): 1380-1385. doi:10.1016/j.pharep.2017.05.013. [26] Wang X, Liang H, Zhou C, et al. Sensitization induces hypersensitivity in trigeminal nerve[J]. Clin Exp Allergy, 2012, 42(11): 1638-1642. doi:10.1111/j.1365-2222.2012.04051.x. [27] Pei Z, Sang H, Li R, et al. Infrasound-induced hemodynamics, ultrastructure, and molecular changes in the rat myocardium[J]. Environ Toxicol, 2007, 22(2): 169-175. doi:10.1002/tox.20244. [28] Jia DZ, Li G. Bioresonance hypothesis: a new mechanism on the pathogenesis of trigeminal neuralgia[J]. Med Hypotheses, 2010, 74(3): 505-507. doi:10.1016/j.mehy.2009.09.056. [29] Sahu MK, Satapathy T, Netam AK, et al. Structural architecture and signal transduction of Ion channels: a review[J]. Rese Jour Pharmacol and Pharmacod, 2018, 10(1): 38. doi:10.5958/2321-5836.2018.00007.1. [30] Subramanyam P, Colecraft HM. Ion channel engineering: perspectives and strategies[J]. J Mol Biol, 2015, 427(1): 190-204. doi:10.1016/j.jmb.2014.09.001. [31] 张宗明, 裘法祖. 离子通道与疾病[J]. 世界华人消化杂志, 2005, 13(5): 585-587. doi:10.3969/j.issn.1009-3079.2005.05.001. ZHANG Zongming, QIU Fazu. Ion channels and diseases[J]. World Chinese Journal of Digestology, 2005, 13(5): 585-587. doi:10.3969/j.issn.1009-3079.2005.05.001. [32] Gambeta E, Chichorro JG, Zamponi GW. Trigeminal neuralgia: an overview from pathophysiology to pharmacological treatments[J]. Mol Pain, 2020, 16: 1744806920901890. doi:10.1177/1744806920901890. [33] Levinson SR, Luo SJ, Henry MA. The role of sodium channels in chronic pain[J]. Muscle Nerve, 2012, 46(2): 155-165. doi:10.1002/mus.23314. [34] Linley JE, Rose K, Ooi L, et al. Understanding inflammatory pain: Ion channels contributing to acute and chronic nociception[J]. Pflugers Arch, 2010, 459(5): 657-669. doi:10.1007/s00424-010-0784-6. [35] Ahn HS, Dib-Hajj SD, Cox JJ, et al. A new Nav1.7 sodium channel mutation I234T in a child with severe pain[J]. Eur J Pain, 2010, 14(9): 944-950. doi:10.1016/j.ejpain.2010.03.007. [36] Matthews EA, Wood JN, Dickenson AH. Na(v)1.8-null mice show stimulus-dependent deficits in spinal neuronal activity[J]. Mol Pain, 2006, 2: 5. doi:10.1186/1744-8069-2-5. [37] Dib-Hajj SD, Black JA, Waxman SG. NaV1.9: a sodium channel linked to human pain[J]. Nat Rev Neurosci, 2015, 16(9): 511-519. doi:10.1038/nrn3977. [38] Lolignier S, Bonnet C, Gaudioso C, et al. The Nav1.9 channel is a key determinant of cold pain sensation and cold allodynia[J]. Cell Rep, 2015, 11(7): 1067-1078. doi:10.1016/j.celrep.2015.04.027. [39] Moulin DE. Pain in central and peripheral demyelinating disorders[J]. Neurol Clin, 1998, 16(4): 889-898. doi:10.1016/s0733-8619(05)70103-1. [40] Henry MA, Luo SJ, Foley BD, et al. Sodium channel expression and localization at demyelinated sites in painful human dental pulp[J]. J Pain, 2009, 10(7): 750-758. doi:10.1016/j.jpain.2009.01.264. [41] Littleton JT, Ganetzky B. Ion channels and synaptic organization: analysis of the Drosophila genome[J]. Neuron, 2000, 26(1):35-43. doi:10.1016/s0896-6273(00)81135-6. [42] Yost CS. Potassium channels:basic aspects, functional roles, and medical significance[J].Anesthesiology,1999,90(4):1186-1203. doi: 10.1097/00000542-199904000-00035. [43] Yoshida S, Matsumoto S. Effects of alpha-dendrotoxin on K+ currents and action potentials in tetrodotoxin-resistant adult rat trigeminal ganglion neurons[J]. J Pharmacol Exp Ther, 2005, 314(1): 437-445. doi:10.1124/jpet.105.084988. [44] Beyak MJ, Vanner S. Inflammation-induced hyperexcitability of nociceptive gastrointestinal DRG neurones: the role of voltage-gated Ion channels[J]. Neurogastroenterol Motil, 2005, 17(2): 175-186. doi:10.1111/j.1365-2982.2004.00596.x. [45] Takeda M, Tanimoto T, Ikeda M, et al. Enhanced excitability of rat trigeminal root ganglion neurons via decrease in A-type potassium currents following temporomandibular joint inflammation[J]. Neuroscience, 2006, 138(2): 621-630. doi:10.1016/j.neuroscience.2005.11.024. [46] Tsantoulas C, McMahon SB. Opening paths to novel analgesics: the role of potassium channels in chronic pain[J]. Trends Neurosci, 2014, 37(3): 146-158. doi:10.1016/j.tins.2013.12.002. [47] Barghaan J, Tozakidou M, Ehmke H, et al. Role of N-terminal domain and accessory subunits in controlling deactivation-inactivation coupling of Kv4.2 channels[J]. Biophys J, 2008, 94(4): 1276-1294. doi:10.1529/biophysj.107.111344. [48] Kraychete DC, Gozzani JL, Kraychete AC. Neuropathic pain: neurochemical aspects[J]. Rev Bras Anestesiol, 2008, 58(5): 498-505, 492-8. doi:10.1590/s0034-70942008000500008. [49] Takeda M, Tanimoto T, Ikeda M, et al. Activaton of GABAB receptor inhibits the excitability of rat small diameter trigeminal root ganglion neurons[J]. Neuroscience, 2004, 123(2): 491-505. doi:10.1016/j.neuroscience.2003.09.022. [50] 孔二亮, 吴飞翔, 俞卫锋. 5-羟色胺受体及其在疼痛调控中的研究进展[J]. 第二军医大学学报, 2016, 37(12): 1517-1523. doi:10.16781/j.0258-879x.2016.12.1517. KONG Erliang, WU Feixiang, YU Weifeng. 5-hydroxytryptamine receptor and its role in pain regulation: research progress[J]. Academic Journal of Second Military Medical University, 2016, 37(12): 1517-1523. doi:10.16781/j.0258-879x.2016.12.1517. [51] Araya EI, Claudino RF, Piovesan EJ, et al. Trigeminal neuralgia: basic and clinical aspects[J]. Curr Neuropharmacol, 2020, 18(2): 109-119. doi:10.2174/1570159X17666191010094350. [52] Zhang AK, Zhang WB, Xu HS, et al. Diabetes mellitus contributes to carbamazepine resistance in patient with trigeminal neuralgia[J]. Neurosurg Rev, 2021,44(2):1119-1125. doi:10.1007/s10143-020-01304-4. [53] Kaya O, Hurel C, Gumussuyu G, et al. Bilateral calcaneal insufficiency fractures due to chronic carbamazepine use for trigeminal neuralgia: a case report[J]. Niger J Clin Pract, 2020, 23(4): 574-576. doi:10.4103/njcp.njcp_515_18. [54] Song HG, Nahm FS. Oxcarbazepine for trigeminal neuralgia may induce lower extremity weakness: a case report[J]. World J Clin Cases, 2020, 8(5): 922-927. doi:10.12998/wjcc.v8.i5.922. [55] Zhang Y, Su Q, Lian Y, et al. Botulinum toxin type A reduces the expression of transient receptor potential melastatin 3 and transient receptor potential vanilloid type 4 in the trigeminal subnucleus caudalis of a rat model of trigeminal neuralgia[J]. Neuroreport, 2019, 30(10): 735-740. doi:10.1097/wnr.0000000000001268. [56] De la Torre Canales G, Poluha RL, Lora VM, et al. Botulinum toxin type A applications for masticatory myofascial pain and trigeminal neuralgia: what is the evidence regarding adverse effects?[J]. Clin Oral Investig, 2019, 23(9): 3411-3421. doi:10.1007/s00784-019-03026-4. [57] Jannetta PJ. Arterial compression of the trigeminal nerve at the Pons in patients with trigeminal neuralgia[J]. J Neurosurg, 1967, 26(1): Suppl:159-Suppl:162. doi:10.3171/jns.1967.26.1part2.0159. [58] Shi J, Qian YT, Han W, et al. Risk factors for outcomes after microvascular decompression for trigeminal neuralgia[J]. World Neurosurg, 2020, 136: e559-e566. doi:10.1016/j.wneu.2020.01.082. [59] Sindou M, Leston J, Howeidy T, et al. Micro-vascular decompression for primary Trigeminal Neuralgia(typical or atypical). Long-term effectiveness on pain; prospective study with survival analysis in a consecutive series of 362 patients[J]. Acta Neurochir(Wien), 2006, 148(12): 1235-1245. doi:10.1007/s00701-006-0809-2. [60] Tavakol S, Jackanich A, Strickland BA, et al. Effectiveness of gamma knife radiosurgery in the treatment of refractory trigeminal neuralgia: a case series[J]. Oper Neurosurg(Hagerstown), 2020, 18(6): 571-576. doi:10.1093/ons/opz311. [61] Petit JH, Herman JM, Nagda S, et al. Radiosurgical treatment of trigeminal neuralgia: evaluating quality of life and treatment outcomes[J]. Int J Radiat Oncol Biol Phys, 2003, 56(4): 1147-1153. doi:10.1016/s0360-3016(03)00264-5. [62] Régis J, Metellus P, Hayashi M, et al. Prospective controlled trial of gamma knife surgery for essential trigeminal neuralgia[J]. J Neurosurg, 2006, 104(6): 913-924. doi:10.3171/jns.2006.104.6.913. [63] Liu HB, Ma Y, Zou JJ, et al. Percutaneous microballoon compression for trigeminal neuralgia[J]. Chin Med J(Engl), 2007, 120(3): 228-230. [64] Udupi BP, Chouhan RS, Dash HH, et al. Comparative evaluation of percutaneous retrogasserian glycerol rhizolysis and radiofrequency thermocoagulation techniques in the management of trigeminal neuralgia[J]. Neurosurgery, 2012, 70(2): 407-412. doi:10.1227/neu.0b013e318233a85f. [65] Meglio M, Cioni B, Moles A, et al. Microvascular decompression versus percutaneous procedures for typical trigeminal neuralgia: personal experience[J]. Stereotact Funct Neurosurg, 1990, 54/55: 76-79. doi:10.1159/000100194. [66] 陶圣余,徐雯,高照,等. 针灸治疗三叉神经痛的用穴规律分析[J]. 中国针灸, 2016, 36(2): 207-211. doi:10.13703/j.0255-2930.2016.02.030. TAO Shengyu, XU Wen, GAO Zhao, et al. Analysis on acupoint selection rule of acupuncture for trigeminal neuralgia [J]. Chinese Acupuncture & Moxibustion,2016, 36(2): 207-211. doi:10.13703/j.0255-2930.2016.02.030. [67] Hu HT, Chen LF, Ma RJ, et al. Acupuncture for primary trigeminal neuralgia: a systematic review and PRISMA-compliant meta-analysis[J]. Complement Ther Clin Pract, 2019, 34: 254-267. doi:10.1016/j.ctcp.2018.12.013. |
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