Diagnostic and therapeutic strategies for secondary trigeminal neuralgia

doi:10.3877/cma.j.issn.1674-0785.2022.07.008

Abstract

Abstract:

Objective

To explore the diagnostic and therapeutic strategies for secondary trigeminal neuralgia (STN).

Methods

The clinical data of 34 STN cases admitted to our hospital from January 2017 to March 2022 were retrospectively analyzed in combination with the relevant literature.

Results

All the 34 cases of STN were caused by space-occupying lesions. All patients received surgical treatment; total excision was achieved in 31 cases, and subtotal excision achieved in 3. Ten cases were found with vascular compression of the trigeminal nerve during operation and underwent microvascular decompression. Postoperatively, pain disappeared in 33 cases and was significantly relieved in 1.

Conclusions

Space-occupying lesions in the CPA area is the primary cause of STN, and classic trigeminal neuralgia may coexist. CT and MRI of the head are essential for STN diagnosis. Surgery is the first choice of treatment for STN. Attention should be paid to vascular compression intraoperatively.

Key words: Secondary trigeminal neuralgia, Space-occupying lesions, Diagnosis, Treatment strategy

Yilin Jiang, Gang Wu, Bo Liu, Jie Shen, Ru'en Liu. Diagnostic and therapeutic strategies for secondary trigeminal neuralgia[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(07): 643-646.

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URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2022.07.008

https://zhlcyszz.cma-cmc.com.cn/EN/Y2022/V16/I07/643

Figures/Tables 3

性别	例数	平均年龄（岁， $x ¯$ ±s）	中位年龄	平均病史（年）	平均发病年龄	中位发病年龄	随访时间（年）
男性	11	53.9±17.3	51.0	5.3	48.6	46.0	2.2
女性	23	52.3±14.4	52.0	3.1	49.2	49.0	2.8
总计	23例	52.2±15.1	51.5	3.8	48.9	48.5	2.6

性别	例数	平均年龄（岁， $x ¯$ ±s）	中位年龄	平均病史（年）	平均发病年龄	中位发病年龄	随访时间（年）
男性	11	53.9±17.3	51.0	5.3	48.6	46.0	2.2
女性	23	52.3±14.4	52.0	3.1	49.2	49.0	2.8
总计	23例	52.2±15.1	51.5	3.8	48.9	48.5	2.6

术前伴随症状	例数	术后短期并发症	例数	病理结果	例数
面瘫	3	面瘫	5	表皮样囊肿	16
面肌痉挛	2	复视	4	脑膜瘤	12
感觉减退	5	脑脊液鼻漏	1	听神经瘤	5
听力下降/耳鸣	8	听力下降	1	三叉神经鞘瘤	1
吞咽困难	1
对侧疼痛	1

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