Trigeminal neuralgia

Trigeminal neuralgia (TN) ndimatenda amitsempha. Zimayambitsa kupweteka ngati kugwedezeka kapena kwamagetsi ngati mbali zina za nkhope.

Zowawa za TN zimachokera ku mitsempha ya trigeminal. Minyewa imeneyi imanyamula ndikumva kupweteka kumaso, m'maso, m'mphuno, ndi pakamwa kupita kuubongo.

Trigeminal neuralgia itha kuyambitsidwa ndi:

• Multiple sclerosis (MS) kapena matenda ena omwe amawononga zoteteza zoteteza myelin yamitsempha
• Kupanikizika pamitsempha yama trigeminal kuchokera mumitsempha yamagazi yotupa kapena chotupa
• Kuvulala kwamitsempha yama trigeminal, monga kuvulala kumaso kapena kuchitidwa opaleshoni yamkamwa kapena sinus

Nthawi zambiri, sizimapezeka chifukwa chenicheni. TN nthawi zambiri imakhudza achikulire azaka zopitilira 50, koma zimatha kuchitika msinkhu uliwonse. Amayi amakhudzidwa nthawi zambiri kuposa amuna. Pamene TN imakhudza anthu ochepera zaka 40, nthawi zambiri imachitika chifukwa cha MS kapena chotupa.

Zizindikiro zimatha kuphatikizira izi:

• Ma spasms opweteka kwambiri, owoneka ngati magetsi omwe nthawi zambiri amatha masekondi angapo mpaka ochepera mphindi 2, koma amatha kukhala osasintha.
• Ululu nthawi zambiri umakhala mbali imodzi yokha ya nkhope, nthawi zambiri mozungulira diso, tsaya, ndi gawo lotsika la nkhope.
• Nthawi zambiri pamakhala kutayika kapena kusunthika kwa gawo lomwe lakhudzidwa ndi nkhope.
• Ululu ukhoza kuyambitsidwa ndi kukhudza kapena mawu.

Zowawa za trigeminal neuralgia zimatha kuyambitsidwa ndi zochitika wamba, zatsiku ndi tsiku, monga:

• Kulankhula
• Kumwetulira
• Kutsuka mano
• Kutafuna
• Kumwa
• Kudya
• Kutentha kapena kutentha
• Kukhudza nkhope
• Kumeta
• Mphepo
• Kugwiritsa ntchito zodzoladzola

Mbali yakumanja ya nkhope imakhudzidwa kwambiri. Nthawi zina, TN imachoka yokha.

Kuyezetsa magazi ndi ubongo (neurologic) nthawi zambiri kumakhala koyenera. Kuyesa komwe kumachitika kuti chifufuze chifukwa chake kungaphatikizepo:

• Kuwerengera kwathunthu kwa magazi
• Mlingo wa sedimentation wa erythrocyte (ESR)
• MRI ya mutu
• MRA (angiography) yaubongo
• Kuyesedwa kwa diso (kuthana ndi matenda a intraocular)
  
• Kujambula pamutu kwa CT (yemwe sangathe kupita ku MRI)
  
• Kuyesedwa kwa Trigeminal reflex (nthawi zambiri)

Dokotala wanu woyang'anira chisamaliro chachikulu, katswiri wa zamagulu, kapena katswiri wazopweteka atha kukhala nawo pachisamaliro chanu.

Mankhwala ena nthawi zina amathandiza kuchepetsa kupweteka komanso kuchuluka kwa ziwopsezo. Mankhwalawa ndi awa:

• Mankhwala oletsa kulanda, monga carbamazepine
• Zotulutsa minofu, monga baclofen
• Tricyclic antidepressants

Kupumula kwakanthawi kochepa kumachitika kudzera mu opaleshoni, koma kumalumikizidwa ndi chiopsezo cha zovuta. Opaleshoni imodzi imatchedwa microvascular decompression (MVD) kapena njira ya Jannetta. Pa nthawi yochita opareshoni, chinthu chonga siponji chimayikidwa pakati pa mitsempha ndi mtsempha wamagazi womwe ukukakamira paminyewa.

Mitsempha ya Trigeminal block (jakisoni) ndi mankhwala oletsa ululu am'deralo ndi steroid ndi njira yabwino kwambiri yothanirana ndi ululu podikirira kuti mankhwala ayambe kugwira ntchito.

Njira zina zimaphatikizapo kuwononga kapena kudula ziwalo za mizu ya trigeminal nerve. Njira zomwe zikugwiritsidwa ntchito zikuphatikiza:

• Kuchepetsa ma radiofrequency (imagwiritsa ntchito kutentha kwapafupipafupi)
• Jekeseni wa glycerol kapena mowa
• Kuponderezana kwaposachedwa
• Mafilimu (amagwiritsa ntchito mphamvu zamagetsi)

Ngati chotupa chimayambitsa TN, opareshoni imachitika kuti ichotsedwe.

Momwe mumachitira bwino zimatengera zomwe zimayambitsa vutoli. Ngati palibe matenda omwe akuyambitsa vutoli, chithandizo chitha kukupatsani mpumulo.

Kwa anthu ena, ululu umakhala wokhazikika komanso wovuta.

Zovuta zingaphatikizepo:

• Zotsatira zoyipa za mankhwala omwe amagwiritsidwa ntchito pochizira TN
• Mavuto obwera chifukwa cha njira, monga kutaya kumverera m'dera lomwe mwachitiridwalo
• Kuchepetsa thupi pakudya osapewa kupweteka
• Kupewa anthu ena mukamalankhula kumayambitsa zowawa
• Matenda okhumudwa, kudzipha
• Kuchuluka kwa nkhawa panthawi yamavuto akulu

Lumikizanani ndi omwe amakuthandizani ngati muli ndi zizindikilo za TN, kapena matenda anu a TN akukulirakulira.

Tic douloureux; Cranial neuralgia; Kupweteka kwa nkhope - trigeminal; Nkhope neuralgia; Mitundu itatu; Matenda opweteka - trigeminal; Kupanda mphamvu kwa Microvascular - trigeminal

• Central dongosolo lamanjenje ndi zotumphukira zamanjenje

Bendtsen L, Zakrzewska JM, Heinskou TB, ndi al. Kupita patsogolo pakuzindikira, kugawa, pathophysiology, ndi kasamalidwe ka trigeminal neuralgia. Lancet Neurol. Chizindikiro. 2019; 19 (9): 784-796. PMID: 32822636 pubed.ncbi.nlm.nih.gov/32822636/.

Gonzales TS. Kupweteka kwa nkhope ndi matenda amitsempha. Mu: Neville BW, Damm DD, Allen CM, Chi AC, olemba. Matenda Amlomo ndi Maxillofacial. Wolemba 4. St Louis, MO: Elsevier; 2016: mutu 18.

Stettler BA. Matenda aubongo ndi mitsempha. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 95.

Waldman SD. Trigeminal neuralgia. Mu: Waldman SD, mkonzi. Atlas of Common Pain Syndromes. Wolemba 4. Philadelphia, PA: Elsevier; 2020: mutu 10.