Névralgies de la face

Pierre Lozeron
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Abstract

Facial nevralgias are rare but debilitating paroxystic or chronic pains. Consensual diagnostic criteria can help to establish the diagnosis, but misleading presentations exist. Trijeminal neuralgia has a pic incidence in women in theirs 1950s. Patients complains of lightning pain in the territory of a branch of the trijeminal nerve. The nerve lesion is most often secondary to a microvascular compression. The pain is triggered by a light sensation on a small area of the face. Pain are severe and sometimes confused with a dental affection. Pharmacotherapy is primarily based on carbamazepine/oxcarbazepine. Microvascular decompression is offered to patients not sufficiently controlled medically. Cluster headache is more common in young men. The pain last 30 minutes to one hour is periorbital. Region and is accompanied by cranial autonomic symptoms. Cluster attacks have a circadian and circumannual rhythmicity. The pathyphysiology is nor fully understood. Intranasal/subcutaneous triptan or high concentration oxygen inhalation are the mainstay of acute treatment. Prevention of cluster recurrence is based on verapamil or lithium administration. Postherpetic neuralgia is defined of the persistence of pain 3 months after a herpes zoster rash. The prevalence of the disease increased with age. It presents as a chronic neuropathic pain that must be treated with appropriate medications. Other facial nevralgias have been described such as occipital or glossopharyngeal nevralgia. Due to their significant impact on quality of life, awareness of the entities is critical an early and to avoid misdiagnosis.

面神经痛是罕见的,但使人衰弱的阵发性或慢性疼痛。双方同意的诊断标准可以帮助建立诊断,但存在误导性的陈述。三叉神经痛在50多岁的女性中发病率较高。病人主诉在三叉神经分支的区域内出现闪电般的疼痛。神经损伤通常继发于微血管压迫。这种疼痛是由面部一小块区域的光感引起的。疼痛很严重,有时会与牙病混淆。药物治疗主要以卡马西平/奥卡西平为基础。微血管减压术适用于医学上控制不充分的病人。丛集性头痛在年轻男性中更为常见。眼眶周围疼痛持续30分钟到1小时。并伴有颅自主神经症状。集束性发作具有昼夜节律和循环节律性。病理生理学尚不完全清楚。鼻内/皮下曲坦类药物或高浓度吸氧是急性治疗的主要方法。预防丛集复发是基于维拉帕米或锂的管理。带状疱疹后神经痛定义为带状疱疹皮疹后疼痛持续3个月。这种疾病的流行率随着年龄的增长而增加。它表现为慢性神经性疼痛,必须用适当的药物治疗。其他面部神经痛也有记载,如枕部或舌咽部神经痛。由于它们对生活质量的重大影响,早期认识这些实体是至关重要的,以避免误诊。
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