Trigeminal neuralgia in the neurosurgical clinic
V.N. Shimansky, V.K. Poshataev, S.V. Tanyashin, M.V. Kolycheva, K.V. Shevchenko
Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
The article illustrates an approach to differential diagnosis, new instrumental methods of examination and principles of surgical treatment of patients with trigeminal neuralgia (TN). The paper presents modern techniques, providing an alternative to the «standard» MRI protocols for visualization of neurovascular conflicts. The approaches and tactics of the surgical treatment of patients with TN depend on the type of neuralgia (classical, symptomatic). An experience of the composite authors includes more than 800 performed operations regarding TN. Much attention is paid to the tactics of patient selection, as well as their observation and further treatment from the viewpoint of a core facility. In patients with pain syndrome at the face area, which is not typical to trigeminal neuralgia, an important step is a timely referral to pathogenetic treatment, which allows avoiding an indication of a surgical treatment and possible risks and complications associated with it, as well as discrediting the highly effective neurosurgical method for treating TN. At all stages of the management of patients with prosopalgia, a cross-disciplinary interaction of different specialists is crucial in clinical practice of which there are patients with orofacial pain, without close interaction with whom it is impossible to imagine the success of a neurosurgeon in treating patients with lesions of cranial nerves of various etiologies.
Key words: prosopalgia, trigeminal neuralgia, vascular decompression.
For citation: Shimansky V.N., Poshataev V.K., Tanyashin S.V. et al. Trigeminal neuralgia in the neurosurgical clinic // RMJ. Medical Review. 2018. № 9. P. 4–9.
References
1. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition // Cephalalgia. 2018. Vol. 38. P. 1–211.
2. Dandy W.E. Section of sensory root of the trigeminal nerve at the pons // Bull Johns Hopkins Hosp. 1925. P. 36–105.
3. Jannetta P.J. Observation on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia: Definitive microsurgical treatment and results of 117 patients // Neurochirurgia. 1977. Vol. 20. P. 145–154.
4. Gronseth G., Cruccu G., Alksne J. et al. Practice parameter: The diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review) // Neurology. 2008. Vol. 71. P. 1183–1190.
5. Wang D., Ouyang D., Englot D. et al. Trends in surgical treatment for trigeminal neuralgia in the United States of America from 1988 to 2008 (Evidence based review) // J Clinical Neuroscience. 2013. Vol. 20. P. 1538–1545.
6. Avelar P., Gonçalves P. Pre-surgical planning of cerebellopontine angle (CPA) tumors using advanced neuroradiological methods // Research Gate. 2018.
7. Шиманский В.Н., Коновалов А.Н., Пошатаев В.К. Васкулярная декомпрессия при невралгии тройничного нерва, гемифациальном спазме, невралгии языкоглоточного нерва. М.: Издательство ИП «Т.А. Алексеева», 2017. 91 с. [Shimanskiy V.N., Konovalov A.N., Poshatayev V.K. Vaskulyarnaya dekompressiya pri nevralgii troynichnogo nerva, gemifatsial’nom spazme, nevralgii yazykoglotochnogo nerva. M.: Izdatel’stvo IP «T.A. Alekseyeva», 2017. 91 s. (in Russian)].
2. Dandy W.E. Section of sensory root of the trigeminal nerve at the pons // Bull Johns Hopkins Hosp. 1925. P. 36–105.
3. Jannetta P.J. Observation on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia: Definitive microsurgical treatment and results of 117 patients // Neurochirurgia. 1977. Vol. 20. P. 145–154.
4. Gronseth G., Cruccu G., Alksne J. et al. Practice parameter: The diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review) // Neurology. 2008. Vol. 71. P. 1183–1190.
5. Wang D., Ouyang D., Englot D. et al. Trends in surgical treatment for trigeminal neuralgia in the United States of America from 1988 to 2008 (Evidence based review) // J Clinical Neuroscience. 2013. Vol. 20. P. 1538–1545.
6. Avelar P., Gonçalves P. Pre-surgical planning of cerebellopontine angle (CPA) tumors using advanced neuroradiological methods // Research Gate. 2018.
7. Шиманский В.Н., Коновалов А.Н., Пошатаев В.К. Васкулярная декомпрессия при невралгии тройничного нерва, гемифациальном спазме, невралгии языкоглоточного нерва. М.: Издательство ИП «Т.А. Алексеева», 2017. 91 с. [Shimanskiy V.N., Konovalov A.N., Poshatayev V.K. Vaskulyarnaya dekompressiya pri nevralgii troynichnogo nerva, gemifatsial’nom spazme, nevralgii yazykoglotochnogo nerva. M.: Izdatel’stvo IP «T.A. Alekseyeva», 2017. 91 s. (in Russian)].
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Previous article
Next article
