Trigeminal neuralgia yog ib qho kab mob inflammatory uas tshwm sim los ntawm ntau cov tsos mob tsis zoo. Tus neeg mob yws ntawm qhov mob hnyav, qhov chaw hauv cheeb tsam uas yuav luag tsis tuaj yeem txiav txim siab. Yog tias cov hlab ntsha trigeminal tau mob, koj yuav tsum nrhiav kev pab kho mob sai li sai tau kom tsis txhob muaj kev cuam tshuam tsis zoo.
Anatomical information
Dab tsi yog lub paj hlwb trigeminal, cov menyuam kawm hauv high school. Tab sis nyob rau hauv cov neeg laus, nws yuav tsum nco ntsoov tsuas yog thaum o tshwm sim. Lub paj hlwb trigeminal yog ib qho loj tshaj ntawm 12 lub paj hlwb. Nws belongs rau hom sib xyaw, muaj kev xav thiab lub cev muaj zog fibers. Peb ceg tawm ntawm trigeminal ganglion - ophthalmic paj hlwb, maxillary paj thiab mandibular paj. Nws yog ua tsaug rau lawv tias rhiab heev ntawm lub ntsej muag, mucous daim nyias nyias ntawm lub qhov ncauj kab noj hniav, thiab cov hniav yog guaranteed. Ua tsaug rau lub cev muaj zog muaj nuj nqi, lawv tuajkev zom zaub mov thiab lwm cov leeg.
Lub paj hlwb trigeminal yog khub. Nws nyob ntawm ob sab ntawm lub taub hau. Lub hauv paus ntawm trigeminal node yog saum pob ntseg. Thaum mob tshwm sim hauv cheeb tsam no, nws tuaj yeem nyuaj rau tus neeg mob piav qhia qhov mob tiag tiag. Cov kev xav tsis zoo tuaj yeem nyob thoob plaws lub ntsej muag lossis muab rau caj dab, tus nplaig, hniav. Qee zaum, qhov mob syndrome tshwm sim nws tus kheej hauv thaj tsam ntawm caj npab, forearm.
Trigeminal raug mob
Tus kab mob no tshwm sim. Raws li kev txheeb cais, txog li 4 tus neeg ntawm 10 txhiab tus neeg raug kev txom nyem los ntawm cov tsos mob tsis zoo. Kev mob ntawm cov hlab ntsha trigeminal hauv ICD-10 tau txais tus lej G50.
Ntau yam tuaj yeem ua rau muaj kev loj hlob ntawm cov txheej txheem pathological. Hauv chav kawm ntawm kev tshawb fawb, nws muaj peev xwm pom tau tias cov neeg uas muaj vascular pathology muaj kev pheej hmoo ntawm o. Neuralgia feem ntau tshwm sim nyob rau hauv cov neeg mob ntshav siab, cerebral atherosclerosis. Mob syndrome yuav tsim nrog aneurysm ntawm lub nkoj nyob ib sab ntawm lub trigeminal node.
Ib pawg sib cais ntawm qhov ua rau suav nrog kev tsim cov khoom ntim - cerebral hlav, neoplasms ntawm cov pob txha pob txha. Ib qho kev tsim nyob rau ntawm lub hauv paus ntawm trigeminal node lossis raws cov ceg tuaj yeem ua rau muaj kev mob hnyav. Compression (squeezing) tshwm, uas ua rau kev loj hlob ntawm neuralgia.
Tus kab mob tuaj yeem tsim tawm tsam keeb kwm ntawm kev nqaim ntawm cov pob txha kwj dej ntawm keeb kwm yav dhau ntawm otitis media, sinusitis, mob taub hau. Malocclusion (congenital los yog kis tau) tuaj yeem ua rau cov tsos mob tsis zoo.
nce zom zom, tsis kam kho raws sijhawm ntawm kev kho hniav, muaj kab mob herpes hauv lub cev, txo kev tiv thaiv - tag nrho cov no tuaj yeem ua rau mob ntawm cov hlab ntsha trigeminal ntawm lub ntsej muag. Tawm tsam keeb kwm yav dhau los ntawm tus kab mob ntev hauv lub cev, kev hloov morphological tshwm sim hauv cov ntaub qhwv fiber ntau. Txawm li cas los xij, thawj cov tsos mob ntawm tus kab mob tsis tas yuav txhim kho tam sim ntawd. Kev puas tsuaj rau cov paj hlwb yuav tsis tshwm sim rau qee lub sijhawm. Mob hnyav, raws li txoj cai, tshwm sim tam sim ntawd - thaum txhuam koj cov hniav, ntxuav koj lub ntsej muag thaum sawv ntxov, luag.
Trigeminal neuralgia ntau dua hauv cov neeg laus uas muaj mob ntev, kab mob ntawm cov hlab plawv, kab mob metabolic.
Signs of disease
Cov hlab ntsha trigeminal tshwm sim li cas ntawm lub ntsej muag? Cov tsos mob tuaj yeem sib txawv heev. Qee tus yws txog qhov mob pob ntseg hnyav, lwm tus maj nrawm mus teem sijhawm nrog tus kws kho hniav vim qhov mob hnyav hauv lawv cov hniav. Feem ntau, cov tsos mob tsis zoo tshwm sim nyob rau thaj tsam ntawm lub puab tsaig sab sauv lossis sab qis. Painkillers tsuas yog kho tus neeg mob ib ntus xwb. Kev mob yuav hnyav dua los ntawm kev zom, hais lus, ntxuav nrog dej txias.
Kev tsis xis nyob feem ntau yog kev voj voog. Qhov mob intensifies, ces subsides. Ntau tus neeg mob tau tshaj tawm tias lawv tau ntsib "hluav taws xob" tom qab kov ib qho chaw ntawm lub ntsej muag. Ib txhiaCov neeg mob muaj kev tsis xis nyob ib zaug lossis ob zaug hauv ib hnub, lwm tus txhua teev.
Ntau tus neeg mob tau ntsib qhov mob atypical. Qhov no npog yuav luag tag nrho lub ntsej muag. Kev txhawj xeeb ntawm qhov tsis tu ncua, nws tsis tuaj yeem txiav txim siab raws nraim qhov chaw nws nyob. Cov txheej txheem pathological kuj tshwm sim los ntawm lwm cov tsos mob - nce salivation, tearing, loog ntawm daim di ncauj thiab hauv pliaj, reddening ntawm daim tawv nqaij, involuntary contraction ntawm cov leeg ntawm lub ntsej muag.
Kev faib tawm
Tus kws kho mob xaiv cov kev kho mob kom raug tom qab nws txiav txim siab yam kab mob. Yog hais tias qhov tseeb ua rau mob ntawm cov hlab ntsha trigeminal tsis tuaj yeem txiav txim siab, cov txheej txheem pathological raug cais raws li idiopathic. Cov kab mob zoo li no nyuaj rau kho, thiab nquag rov qab los tau.
Secondary lossis symptomatic trigeminal neuralgia yog tshwm sim los ntawm cov kab mob ntev, vascular disorders, qog, pob txha hloov. Nws muaj peev xwm tshem tawm cov tsos mob tsis zoo vim yog kev kho tus kab mob hauv qab.
Diagnosis
tuaj yeem yooj yim tsis meej pem nrog lwm tus kab mob uas muaj cov tsos mob zoo sib xws, o ntawm lub ntsej muag trigeminal paj hlwb. Tus kws kho mob sau ntawv kho mob tsuas yog tom qab kuaj xyuas kom meej. Nrog rau qhov tshwm sim ntawm cov tsos mob tau piav qhia saum toj no, tus neeg mob yuav tsum tau teem sijhawm nrog tus kws kho mob hlwb. Tus kws kho mob tshwj xeeb tuaj yeem ua qhov kev kuaj mob ua ntej tom qab kuaj xyuas, nrog rau raws li cov neeg mob tsis txaus siab. Nws yog ua tau kom paub tseeb tias koj yuav tsum tau nrog trigeminal neuralgia ua tsaug raucov hauv qab no:
- Computed tomography ntawm pob txha taub hau. Cov txheej txheem ua rau nws muaj peev xwm txiav txim siab qhov hloov pauv ntawm qhov loj thiab qhov txheeb ze ntawm cov pob txha pob txha pob txha. Yog tias muaj qog nqaij hlav, hlwv lossis lwm yam kev loj hlob hauv thaj tsam ntawm cov hlab ntsha trigeminal, qhov no tuaj yeem txiav txim siab.
- Magnetic resonance imaging ntawm lub hlwb. Txoj kev tshawb no yog ua tau yog hais tias ib pawg yog xav tias yuav compressed trigeminal node los yog paj hlwb ceg. Cov txheej txheem kuj tso cai rau pom cov qog me me thiab cov hlwv.
- MR angiography. Cov txheej txheem ua rau nws muaj peev xwm txheeb xyuas lossis tshem tawm cov kab mob ntawm cov hlab ntsha nyob hauv thaj tsam ntawm cov hlab ntsha trigeminal.
Thaum o ntawm cov hlab ntsha trigeminal ntawm lub ntsej muag, cov tsos mob tuaj yeem sib txawv. Yog hais tias, ntxiv rau qhov mob, muaj reddening ntawm daim tawv nqaij, o, tearing, tej zaum koj yuav tau mus sab laj nrog kws kho mob tshwj xeeb (ophthalmologist, dermatologist, kws kho hniav, otolaryngologist, thiab lwm yam).
Tshuaj kho kab mob
Nrog rau sijhawm nkag mus rau kev kho mob tsim nyog, kev saib xyuas kev kho mob qhia tau zoo. Kev kho mob feem ntau yog tsom rau kev txwv tsis pub hyperexcitation ntawm paj hlwb. Cov txiaj ntsig zoo tau pom los ntawm cov tshuaj los ntawm cov pab pawg ntawm cov tshuaj tiv thaiv kab mob. Ntau tus neeg mob tau muab tshuaj "Carbamazepine". Kev kho mob pib nrog qhov tsawg kawg nkaus, tom qab ntawd nce tus nqi txhua hnub kom ua tiav cov txiaj ntsig zoo. Tom qab ua tiav qhov kev xav tau (kev tshem tawm qhov mob), kev kho mobnws yuav siv li ob peb lub hlis ntxiv los muab cov txiaj ntsig sib sau ua ke. Yog tias cov tshuaj raug tso tseg ua ntej, qhov rov tshwm sim tuaj yeem tshwm sim.
Kev kho mob pab kuj tseem ceeb heev. Cov tshuaj uas tsis yog-steroidal anti-inflammatory (Ketorol, Nalgezin), antispasmodics (Spasmolgon, Papaverine) tuaj yeem siv los txo qhov mob. Antihistamines (Tavegil, Supradin) pab txo qis puffiness thiab rov zoo li qub.
Kev swb ntawm cov hlab ntsha trigeminal, raws li txoj cai, rov tshwm sim dua. Yog hais tias ib zaug koj twb tau nrog cov tsos mob tsis kaj siab, tus kab mob tuaj yeem tshwm sim nws tus kheej dua. Yog li ntawd, nws yog ib qho tseem ceeb rau tus neeg mob kom tsis txhob hypothermia, txwv txoj kev zom zaub mov, thiab tsis tu ncua mus soj ntsuam los ntawm ib tug neurologist. Thaum lub sij hawm exacerbation ntawm tus kab mob, nws yog tsim nyog tso tseg tej kev ua si lub cev. Lub txaj so yuav tsis yog superfluous. Kev so zoo yuav txhim kho cov txiaj ntsig ntawm kev kho tshuaj. Nws raug pom zoo ib ntus kom tso tseg qhov muag pom ntau dhau.
Thaum tus kab mob exacerbation, thaum o ntawm cov hlab ntsha trigeminal ntawm lub ntsej muag manifests nws tus kheej nrog excruciating mob, kev kho mob yog nqa tawm siv zog tshuaj loog. Cov txiaj ntsig zoo kuj tseem pom los ntawm kev qhia txog cov tshuaj hormones glucocorticoid rau hauv cov ntsiab lus trieric.
kho lub cev
Cov txiaj ntsig zoo tsuas yog ua tiav los ntawm kev kho mob ntawm cov hlab ntsha trigeminal ntawm lub ntsej muag. Cov tsos mob kuj tuaj yeem kov yeej nrog kev siv cov txheej txheem physiotherapy. Qhia tau zoogalvanization nrog novocaine. Los ntawm daim tawv nqaij nyob rau hauv qhov chaw ntawm qhov mob, qhov hluav taws xob tsawg-voltage tam sim no yog siv. Cov txheej txheem tso cai rau koj kom txo tau qhov tshwm sim ntawm qhov mob, ua kom cov txheej txheem rov tsim dua tshiab ntawm cov fibers cuam tshuam.
Nrog kev pab ntawm diadynamic tam sim no, o ntawm cov hlab ntsha trigeminal kuj tau kho. Daim duab ntawm tus txheej txheem tuaj yeem pom hauv qab no. Cov cheeb tsam cuam tshuam yog cuam tshuam los ntawm polysinusoidal tam sim no. Cov txheej txheem yuav pab kom tshem tawm qhov mob sai sai. Thaum pib, cov txheej txheem tuaj yeem ua tau ntau zaus hauv ib hnub.
Nws tuaj yeem ua tiav cov txiaj ntsig zoo ua tsaug rau kev qhia cov tshuaj rau hauv lub cev siv ultrasound. Cov txheej txheem hu ua ultraphonophoresis. Kev kho mob yog nqa tawm nrog kev siv cov glucocorticoids. Twb tau thawj hnub ntawm kev kho mob, nws tuaj yeem nres qhov mob hnyav, pib cov txheej txheem rov qab los ntawm cov hlab ntsha cuam tshuam.
Kev kho lub cev kho mob qhia tau zoo. Txawm li cas los xij, rau lawv qhov kev siv yuav tsum muaj pov thawj. Nws yog categorically tsis yooj yim sua kom siv xws li cov tswv yim nyob rau hauv lub xub ntiag ntawm malignant qog los yog aneurysms nyob rau hauv lub cheeb tsam ntawm lub trigeminal node.
Surgery
Txoj kev kho kom zoo tsis yog ib txwm ua tau zoo. Yog tias cov tsos mob tsis ploj mus nrog kev mob ntawm cov hlab ntsha trigeminal ntawm lub ntsej muag, tus kws kho mob yuav txiav txim siab ua kev phais. Qhov kev xav tau no kuj tseem tuaj yeem tshwm sim thaum muaj cov neoplasms hauv thaj chaw cuam tshuam.
Microsurgical decompression yog ib txoj hauv kevradical phais tshem tawm ntawm neuralgia. Ib qho me me burr qhov yog ua nyob rau hauv qab ntawm pob ntseg cheeb tsam, los ntawm qhov uas tus kws phais tau ntxig cov cuab yeej nrog lub tshuab tsom. Qhov kev cuam tshuam tsuas yog ua raws li kev tshuaj loog. Yog li ntawd, cov neeg mob laus (ntau dua 70 xyoo) muaj kev pheej hmoo ntawm kev mob plawv.
Percutaneous radiofrequency kev puas tsuaj yog suav hais tias yog ib txoj hauv kev tsawg dua. Cov txheej txheem muaj ntau yam txiaj ntsig. Tus kws tshaj lij tuaj yeem ua tau yooj yim rau thaj chaw me me yam tsis muaj kev puas tsuaj rau cov paj hlwb uas nyob ib sab. Kev rov zoo ntawm tus neeg mob yog qhov nrawm heev. Qhov kev pheej hmoo ntawm cov teeb meem yog tsawg. Hauv ib lub lis piam tom qab kev phais, tus neeg tuaj yeem rov qab mus rau lub neej tag nrho. Yog tias kev puas tsuaj radiofrequency tau ua tiav lawm, cov txiaj ntsig ntawm nws qhov kev siv yuav kav ntau xyoo. Tus neeg mob ntev ntev tsis nco qab tias cov hlab ntsha trigeminal yog dab tsi. Txawm li cas los xij, kev rov qab los, hmoov tsis, tsis yog ib txwm zam.
Stereotactic radiosurgery tuaj yeem ua tau nyob rau hauv lub xub ntiag ntawm formations nyob rau hauv lub trigeminal paj hlwb. Qhov no yog cov txheej txheem minimally invasive uas tso cai rau koj nkag mus rau hauv cov ntaub so ntswg yam tsis muaj kev pheej hmoo ntau thiab rhuav tshem cov qog ntawm qib cellular. Nws tsis ua rau cov qauv tseem ceeb.
tshuaj ntsuab
Kom hnov qab mus ib txhis txog dab tsi lub paj hlwb trigeminal, txhua txoj hauv kev yog qhov zoo. Cov zaub mov noj tshuaj tseem nrov. Ib txhia ntawm lawv yeej qhia siab efficiency. Txawm li cas los xij, nws yog ib qho tseem ceeb uas yuav tau tham txog txhua txoj kev kho nrog koj tus kws kho mob txhawm rau zamkev loj hlob ntawm cov teeb meem.
Rau kev kho mob ntawm cov kab mob hauv lub paj hlwb, kev kho mob raws li cov tshuaj ntsuab tau siv dav: burdock, aloe, txiv qaub balm, geranium, yarrow, thiab lwm yam. Cov tshuaj pleev ib ce thiab infusions rau noj tuaj yeem coj cov hlab ntsha trigeminal rov qab. ua li qub. Qhov twg thiaj li tau txais cov ntaub ntawv raw rau kev npaj cov nyiaj? Cov nroj tsuag tshuaj tuaj yeem sau tau ntawm nws tus kheej lossis yuav hauv lub tsev muag tshuaj hauv daim ntawv qhuav.
Cov txiaj ntsig tau zoo yog pom los ntawm cov tshuaj decoction raws li mint, valerian thiab St. John's wort. Qhuav raw cov ntaub ntawv yog tov nyob rau hauv sib npaug proportions (150-200 g txhua). Ob dia ntawm lub resulting sib tov yog poured nrog ib nrab ib liter dej, coj mus rau ib tug boil thiab simmered rau lwm 10 feeb. Tom qab ntawd cov khoom yuav tsum tau txias thiab insisted rau lwm 5 teev nyob rau hauv ib qho chaw tsaus. Cov tshuaj tiav lawm yog lim thiab noj nyob rau hauv ib tablespoon peb zaug ib hnub twg rau ob lub lis piam.
Yog tias cov tsos mob ntawm qhov mob ntawm lub ntsej muag trigeminal tshwm sim, kev kho mob hauv tsev tuaj yeem ua tiav nrog decoction raws li burdock thiab chamomile. Cov khoom xyaw qhuav yog tov nyob rau hauv sib npaug zos proportions, 300 g ntawm qhov sib tov yog poured nrog ib nrab ib liter dej, coj mus rau ib tug boil thiab boil rau lwm 15 feeb. Cov tshuaj tiav lawm yog infused thaum nruab hnub nyob rau hauv lub hau kaw, ces lim. Lub infusion yog qaug dej qaug cawv thoob plaws hnub tom qab hauv me me sips.
Yog tias koj yuav tsum paub seb lub paj hlwb trigeminal yog dab tsi thiab nws qhov mob tshwm sim li cas, koj yuav tsum tau xyuam xim rau aloe. Cov nroj tsuag no yuav pab tshem tawm qhov mob, ua kom cov txheej txheem rov tsim dua ntawm cov ntaub so ntswg. Rau Kev Kho Mobaloe yuav tsum tau siv, lub hnub nyoog uas tsis tshaj peb xyoos. Ib teaspoon ntawm cov kua txiv hmab txiv ntoo yuav tsum tau noj peb zaug ib hnub ua ntej noj mov. Cov neeg uas muaj kev fab tshuaj yuav tsum tsis kam kho li no.
Yog tias cov tsos mob tsis zoo tshwm sim, kev kho mob ntawm cov hlab ntsha trigeminal hauv tsev tuaj yeem ua tiav siv cov kua txiv birch. Cov dej haus muaj ib tug tshwj xeeb muaj pes tsawg leeg, nrog rau nws pab koj muaj peev xwm tiv nrog o, ntxiv dag zog rau lub cev tiv thaiv. Haus tsawg kawg ob khob ib hnub. Birch kua txiv kuj tseem siv tau los ntxuav lub ntsej muag.
Ntau hom tshuaj pleev ib ce tau siv dav. Geranium yuav pab tau sai sai txo qhov mob nyob rau hauv cov ntaub ntawv ntawm o ntawm cov hlab ntsha trigeminal. Cov nroj tsuag txiav yog siv rau qhov chaw mob, fastened nrog ib tug gauze bandage. Tom qab ob peb teev, cov tshuaj pleev yog tshem tawm thiab siv cov nroj tsuag tshiab.
Compresses los ntawm cov hauv paus marshmallow yog siv tau. Ob peb lub hauv paus yog crushed thiab ncuav 200 ml ntawm boiling dej. Cov cuab yeej yuav tsum tau infused txhua hnub. Nyob rau hauv cov khoom tiav, ib daim ntaub qhwv los yog linen yog moistened, squeezed thiab siv rau thaj tsam cuam tshuam. Ib daim phuam sov yog muab tso rau saum. Lub sijhawm ntawm cov txheej txheem yog 30-40 feeb. Koj tuaj yeem ua raws li kev kho mob ntau zaus hauv ib hnub.
Kev kho mob thiab kev tiv thaiv
Koj yuav tsum tsis txhob ncua mus ntsib kws kho mob yog tias lub ntsej muag trigeminal tau ua rau nws tus kheej muaj cov tsos mob tsis zoo. Kev kho mob thaum ntxov qhia tau tias muaj txiaj ntsig zoo. Nws yog ib qho ua tau kom tshem tau cov cim tsis zoo tag nrho. Nws yog qhov tsis yooj yim sua kom koom nrog kev kho tus kheej. Nws yuavua rau muaj kev phom sij txaus ntshai.
Paresis ntawm lub ntsej muag cov leeg yog qhov tshwm sim ntawm kev kho tsis raug ntawm kev mob ntawm cov hlab ntsha trigeminal. Cov nqaij ntshiv ntawm lub ntsej muag ua tsis muaj zog, ua haujlwm ua haujlwm tsawg. Yog li ntawd, lub ntsej muag deformity tsim. Qhov no yog qhov tsis xws luag zoo nkauj uas ua rau muaj kev puas siab puas ntsws complexes.
Kev kho tsis raug ntawm cov hlab ntsha trigeminal ntawm lub ntsej muag tuaj yeem ua rau hnov qab thiab tsis pom kev. Tus neeg mob poob peev xwm los daws cov haujlwm yooj yim txhua hnub.
Yog tias koj twb tau mus nrog o ntawm cov hlab ntsha ntawm lub ntsej muag trigeminal, yuav tsum tau them nyiaj tshwj xeeb rau kev tiv thaiv kev rov qab los. Nws yog ib qho tseem ceeb kom tsis tu ncua kev soj ntsuam nrog ib tug neurologist, kho tej yam kab mob nyob rau hauv raws sij hawm, thiab mus soj ntsuam kev tiv thaiv ntawm tus kws kho hniav. Yog tias qhov mob tshwm sim, koj yuav tsum mus ntsib kws kho mob tam sim ntawd.
