求助帖: 三叉神经痛

s
sharppink
楼主 (北美华人网)



上周坐飞机的时候, 突然三叉神经痛, 从前只是听说过, 百闻不如一受,真的疼的要人命。一度我以为我要面瘫了 我也是头一次出现这种情况, 不知道这种该怎么预防? 我是不是该去找家庭医生refer个神经科医生看看?
我也没吃药,就大概十五分钟自己就扛过去了。
先谢谢大家的帮助
g
gloria1091
我奶奶从50岁开始三叉神经痛,也是靠忍着。据说没有什么好办法。
l
laalaatou
我爷爷也是三叉神经问题,晚年时脸没有一刻不在抽搐的。我也好害怕自己遗传到。据说手术可以治疗。
a
aibeca
听别人说起过,做手术可以
y
yolandos
不知道针灸行不行
a
andrew70912
回复 1楼sharppink的帖子
如果初发的典型的三叉神经痛,建议你就诊神经科,需要做神经系统的检查,包括brain mri, 需要排除继发性原因,像肿瘤压迫或者多发性硬化症等。
A
April4
朋友的妈妈查出来这个 刚做了手术
L
Lotusconnie
回复 6楼的帖子
同意这个回复。copy paste UpToDate上的一段话供参考。这段话还挺吓人的,希望不会让楼主太紧张。一般没事的。只是让你了解一下相关信息。见到医生时心里有数。
SUMMARY AND RECOMMENDATIONS ●Compression of the trigeminal nerve root is the main mechanism of trigeminal neuralgia (TN), but brainstem lesions account for a small proportion of cases. (See ''Mechanisms'' above.)
●TN is defined clinically by sudden, usually unilateral, severe, brief, stabbing or lancinating, recurrent episodes of pain in the distribution of one or more branches of the fifth cranial (trigeminal) nerve that are triggered by stimulation of the affected trigeminal division. (See ''Clinical features'' above.)
●The diagnosis of TN is based upon the characteristic clinical features. For all patients with suspected TN, we recommend neuroimaging to help define the underlying cause (algorithm 1). Magnetic resonance imaging (MRI) is the preferred imaging method because of its higher resolution compared with computed tomography (CT). (See ''Imaging''above.)
●The differential diagnosis of classic TN includes conditions that cause classic TN and secondary TN, mainly compression of the trigeminal nerve by a vascular loop or a nonvascular space-occupying lesion, and demyelination from multiple sclerosis in the pons or root entry zone of the trigeminal nerve. Uncommon causes of headache and craniofacial pain in the differential include short-lasting unilateral neuralgiform headache attacks, cluster-tic syndrome, first bite syndrome, and primary stabbing headache. In addition, TN can sometimes be confused with dental causes of pain. Although less likely to be confused with TN, the differential diagnosis also includes various causes of painful trigeminal neuropathy, such as acute herpes zoster, postherpetic neuralgia, and trauma to the trigeminal nerve. (See ''Differential diagnosis'' above.)
●Pharmacologic therapy is used for initial treatment of most patients with TN. (See ''Medical treatment'' above.)
•For patients with TN who require pain control, we recommend carbamazepine or oxcarbazepine as initial therapy (Grade 1A). Some experts advise early surgical referral for patients who fail to respond to first-line therapy. (See ''First-line therapy'' above.)
•For patients with TN who are intolerant of or have contraindications to carbamazepineand oxcarbazepine, we suggest treatment with gabapentin, lamotrigine, or baclofen (Grade 2C). (See ''Alternatives and adjuncts to first-line therapy'' above.)
•For patients with TN who are nonresponders to first-line agents but wish to avoid or delay surgery, we suggest switching to or adding on gabapentin, lamotrigine, or baclofen. (See ''Alternatives and adjuncts to first-line therapy'' above.)
While no medications have been established as effective for the treatment of secondary TN, patients with secondary TN often respond well to the same medications that are employed in classic and idiopathic TN. (See ''Medical treatment'' above.)
●Intravenous infusion of lidocaine, phenytoin, or fosphenytoin, or subcutaneous injections of sumatriptan can provide analgesia for patients with TN while oral medications are titrated. (See ''Rescue therapy'' above.)
●For patients with TN refractory to medical therapy, it is reasonable to discuss options for surgical therapy using microvascular decompression (for TN caused by compression of the trigeminal nerve root), various types of rhizotomy, or gamma knife radiosurgery. The decision to have surgery and the choice among surgical options will be influenced by individual circumstances including patient preference, adverse effect profile of the available techniques, and expertise of the local center. (See ''Surgery for medically refractory TN'' above.)

蔡英文
北京中日友好医院神经外科
不用谢
k
katie1433
Advil 很有效果,试试

普罗旺斯的淡紫
我妈妈和舅舅都是吃中药好了。