Sercan KÜÇÜKKURT, Hüseyin Can TÜKEL, Murat ÖZLE

TRİGEMİNAL NEVRALJİ

Trigeminal nevralji (TN), hastanın yaşam kalitesini oldukça düşüren şiddetli ağrılar ile karakterize, hastaların yüksek intihar eğilimi nedeniyle “intihar hastalığı” olarakta bilinen bir nevropatik hastalıktır. Teşhisinin zor olması ve bulguların birçok başka hastalık ile karıştırılması nedeniyle, hastalığın toplumda görülme oranlarının rapor edilene göre oldukça yüksek olduğu tahmin edilmektedir. Geçmişten günümüze tedavisi ile ilgili yapılan tüm çalışmalarda ortak payda, hastalığa ne kadar erken müdahele edilirse, hastanın ağrılarının azaltılma ihtimalinin o kadar yüksek olacağıdır. TN’nin semptomlarının diş kaynaklı ağrılar ile ilişkilendirilmesi sıklıkla karşılaşılan bir durumdur. Genellikle bu tip hastalarda ilgili bölgedeki diş ya da dişlere kanal tedavisi yapıldığı hatta çekildiği görülür. Bu durum hem hastanın sağlıklı dişlerinin gereksiz ve yanlış tedaviler görmesine yol açmakta hem de TN teşhisinin konulmasını geciktirmektedir. Dolayısıyla diş hekiminin trgimenial nevralji hakkında bilgi sahibi olması ve bu bölgelerde yaşanan ağrılar konusunda ayırıcı tanılara eklemesi önem taşımaktadır. Bu derlemede geçmişten günümüze literatür bilgilerinden TN teşhis ve tedavileri hakkında hekimlerin bilgi edinebilecekleri bir kaynak oluşturulması amaçlanmıştır. Anahtar Kelimeler: trigeminal nevralji, fasiyal ağrı, trigeminal sinir, trigeminal sinir hastalıkları, myofasiyal ağrı sendromları TRIGEMINAL NEURALGIA ABSTRACT Trigeminal neuralgia (TN) is a neuropathic disorder known as "suicide disease" due to the high suicidal tendency of the patients, characterized by severe pain that significantly reduces the quality of life of the patient. Because the diagnosis is difficult and the findings are similar with many other diseases, it is estimated that the incidence of the disease in the society is considerably higher than reported. The consensus in all the studies on past day-to-day treatment is that The sooner the disease is diagnosed, its the more likely the patient's pain will be treated. It is often the case that the symptoms of TN are associated with tooth-borne pain. Generally, it is seen that in this kind of cases, the tooth or teeth in the related region are root canal treated or even extracted. This leads to unnecessary and incorrect treatment of the healthy teeth of the patient as well as delaying the diagnosis of TN. Therefore, it is important for the dentist to have knowledge about trigeminal neuralgia and add this disease for the differential diagnosis of pain in these areas. In this review, it is aimed to create a resource that physicians can learn about TN diagnosis and treatments from the contemporary literature data. Keywords: trigeminal neuralgia, facial pain, trigeminal nerve, trigeminal nerve diseases, myofascial pain syndromes

Anahtar Kelimeler:

trigeminal nevralji, fasiyal ağrı, trigeminal sinir, trigeminal sinir hastalıkları

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1. Samadian M, Bakhtevari MH, Nosari MA, Babadi AJ, Razaei O. Trigeminal Neuralgia Caused by Venous Angioma: A Case Report and Review of the Literature. World Neurosurg. 2015;84:860-4.
2. Montano N, Conforti G, Di Bonaventura R, Meglio M, Fernandez E, Papacci F. Advances in diagnosis and treatment of trigeminal neuralgia. Ther Clin Risk Manag. 2015;11:289-99.
3. Guardiani E, Sadoughi B, Blitzer A, Sirois D. A new treatment paradigm for trigeminal neuralgia using Botulinum toxin type A. Laryngoscope. 2014;124:413-7.
4. Falaki F, Nejat AH, Dalirsani Z. The Effect of Low-level Laser Therapy on Trigeminal Neuralgia: A Review of Literature. J Dent Res Dent Clin Dent Prospects. 2014;8:1-5.
5. Headache Classification Committee of the International Headache S. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33:629-808.
6. Güngörmüş M, Tozoğlu S, Büyükkurt MC, Yavuz MS. Oral Bölgede Sık Karşılaşılan Akut Ağrılı Durumlar. J Dent Fac Atatürk Uni. 2002;12:1-3.
7. Zakrzewska JM. Diagnosis and differential diagnosis of trigeminal neuralgia. Clin J Pain. 2002;18:14-21.
8. Jurge S. Pain. Part 7: Trigeminal Neuralgia. Dent Update. 2016;43:138-40, 43-6, 49.
9. Limonadi FM, McCartney S, Burchiel KJ. Design of an artificial neural network for diagnosis of facial pain syndromes. Stereotact Funct Neurosurg. 2006;84:212-20.
10. Mazhari A. Multiple Sclerosis-Related Pain Syndromes: An Imaging Update. Curr Pain Headache Rep. 2016;20:63.
21. Quail G. Atypical facial pain--a diagnostic challenge. Aust Fam Physician. 2005;34:641-5.
22. Sindrup SH, Jensen TS. Pharmacotherapy of trigeminal neuralgia. Clin J Pain. 2002;18:22-7.
23. Al-Quliti KW. Update on neuropathic pain treatment for trigeminal neuralgia. The pharmacological and surgical options. Neurosciences (Riyadh). 2015;20:107-14.
24. Oh HM, Chung ME. Botulinum Toxin for Neuropathic Pain: A Review of the Literature. Toxins (Basel). 2015;7:3127-54.
25. Granger P, Biton B, Faure C, Vige X, Depoortere H, Graham D, et al. Modulation of the gamma-aminobutyric acid type A receptor by the antiepileptic drugs carbamazepine and phenytoin. Mol Pharmacol. 1995;47:1189-96.
26. Birse F, Derry S, Moore RA. Phenytoin for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev. 2012:CD009485.
27. Cheshire WP. Trigeminal neuralgia: for one nerve a multitude of treatments. Expert Rev Neurother. 2007;7:1565-79.
28. Barker FG, 2nd, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD. The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med. 1996;334:1077-83.
29. Delitala A, Brunori A, Chiappetta F. Microsurgical posterior fossa exploration for trigeminal neuralgia: a study on 48 cases. Minim Invasive Neurosurg. 2001;44:152-6.
30. Bederson JB, Wilson CB. Evaluation of microvascular decompression and partial sensory rhizotomy in 252 cases of trigeminal neuralgia. J Neurosurg. 1989;71:359-67.
41. Liu M, Wu CY, Liu YG, Wang HW, Meng FG. Three-dimensional computed tomography-guided radiofrequency trigeminal rhizotomy for treatment of idiopathic trigeminal neuralgia. Chin Med Sci J. 2005;20:206-9.
42. Cheng JS, Lim DA, Chang EF, Barbaro NM. A Review of Percutaneous Treatments for Trigeminal Neuralgia. Neurosurgery. 2013.
43. Bennett MH, Lunsford LD. Percutaneous retrogasserian glycerol rhizotomy for tic douloureux: Part 2. Results nd implications of trigeminal evoked potential studies. Neurosurgery. 1984;14:431-5.
44. Hakanson S. Trigeminal neuralgia treated by the injection of glycerol into the trigeminal cistern. Neurosurgery. 1981;9:638-46.
45. Asplund P, Blomstedt P, Bergenheim AT. Percutaneous Balloon Compression vs Percutaneous Retrogasserian Glycerol Rhizotomy for the Primary Treatment of Trigeminal Neuralgia. Neurosurgery. 2016;78:421-8; discussion 8.
46. Missios S, Mohammadi AM, Barnett GH. Percutaneous treatments for trigeminal neuralgia. Neurosurg Clin N Am. 2014;25:751-62.
47. Pollock BE. Percutaneous retrogasserian glycerol rhizotomy for patients with idiopathic trigeminal neuralgia: a prospective analysis of factors related to pain relief. J Neurosurg. 2005;102:223-8.
48. Yue WL. Peripheral glycerol injection for the relief of facial neuralgia in children. Int J Pediatr Otorhinolaryngol. 2004;68:37-41.
49. Yue WL, Ding DL. Effects of perineural application of glycerol on the facial nerve: an experimental study. Eur Arch Otorhinolaryngol. 2001;258:501-4.
50. Erdem E, Alkan A. Peripheral glycerol injections in the treatment of idiopathic trigeminal neuralgia: retrospective analysis of 157 cases. J Oral Maxillofac Surg. 2001;59:1176-80.
61. Lim M, Villavicencio AT, Burneikiene S, Chang SD, Romanelli P, McNeely L, et al. CyberKnife radiosurgery for idiopathic trigeminal neuralgia. Neurosurg Focus. 2005;18:E9.
62. Villavicencio AT, Lim M, Burneikiene S, Romanelli P, Adler JR, McNeely L, et al. Cyberknife radiosurgery for trigeminal neuralgia treatment: a preliminary multicenter experience. Neurosurgery. 2008;62:647-55; discussion -55.
63. Rahnama M, Gaweda A. Trigeminal neuralgia--own observations. Ann Univ Mariae Curie Sklodowska Med. 2003;58:185-6.
64. Poon CY. Cryotherapy in the management of trigeminal neuralgia: a review of the literature and report of three cases. Singapore Dent J. 2000;23:49-55.
65. Zakrzewska JM, Nally FF. The role of cryotherapy (cryoanalgesia) in the management of paroxysmal trigeminal neuralgia: a six year experience. Br J Oral Maxillofac Surg. 1988;26:18-25.
66. Pradel W, Hlawitschka M, Eckelt U, Herzog R, Koch K. Cryosurgical treatment of genuine trigeminal neuralgia. Br J Oral Maxillofac Surg. 2002;40:244-7.
67. Fardy MJ, Patton DW. Complications associated with peripheral alcohol injections in the management of trigeminal neuralgia. Br J Oral Maxillofac Surg. 1994;32:387-91.
68. Littler BO. Alcohol blockade of the inferior dental nerve under radiographic control in the management of trigeminal neuralgia. Oral Surg Oral Med Oral Pathol. 1984;57:132-5.
69. Peters G, Nurmikko TJ. Peripheral and gasserian ganglion-level procedures for the treatment of trigeminal neuralgia. Clin J Pain. 2002;18:28-34.
70. Shiotani M. Trigeminal neuralgia. Pain Clinic. 1992;13:867–74.