Trigeminal neuralgia

Trigeminal neuralgia (TN) chirwere chetsinga. Iyo inokonzeresa yekurovera kana yemagetsi kuvhunduka-senge kurwadziwa mune zvikamu zveuso.

Iko kurwadziwa kweTN kunouya kubva kuhutatu hwemitsipa. Iyi tsinga inotakura manzwiro ekubata uye kurwadziwa kubva kumeso, maziso, zvitadzo, uye muromo kuenda kuuropi.

Trigeminal neuralgia inogona kukonzerwa ne:

• Multiple sclerosis (MS) kana zvimwe zvirwere zvinokanganisa chidziviriro chekufukidza myelin yemitsipa
• Kumanikidza pamutsipa wehutatu kubva kuzvimba kweropa mudziyo kana bundu
• Kukuvadza kune tsinga dzemutatu, senge kubva mukukuvara kusvika kumeso kana kubva mukuvhiya kwemuromo kana kwechivi

Kazhinji, hapana chikonzero chaicho chinowanikwa. TN inowanzo bata vanhu vakuru vanopfuura makore makumi mashanu, asi inogona kuitika chero pazera. Vakadzi vanobatwa kazhinji kazhinji kupfuura varume. Kana TN ikabata vanhu vadiki pane makumi mana, inowanzo kukonzerwa neMS kana bundu.

Zviratidzo zvinogona kusanganisira chero zvinotevera:

• Inorwadza kwazvo, inopinza yemagetsi-kunge spasms ayo anowanzo gara kubva akati wandei masekondi kusvika isingasvike maminetsi maviri, asi inogona kuramba ichiita.
• Marwadzo anowanzo kuve kune rumwe rutivi rwechiso, kazhinji kutenderedza ziso, dama, uye chikamu chepasi chechiso.
• Iko hakuna kazhinji kurasikirwa kwekunzwa kana kufamba kwechikamu chakakanganiswa chechiso.
• Marwadzo anogona kukonzerwa nekubata kana kurira.

Kurwiswa kunorwadza kwetrigeminal neuralgia kunogona kukonzerwa neyakajairika, zviitiko zvezuva nezuva, zvakaita se:

• Kutaura
• Kunyemwerera
• Kukwesha mazino
• Kutsenga
• Kunwa
• Kudya
• Kuratidzira kune inopisa kana inotonhora tembiricha
• Kubata kumeso
• Kuveura ndebvu
• Mhepo
• Kuisa make-up

Rutivi rworudyi rwechiso runonyanya kukanganiswa. Mune zvimwe zviitiko, TN inoenda yega.

Uropi uye huta hurongwa (neurologic) kuongororwa kunowanzoitika. Kuyedzwa kunoitwa kutsvaga chikonzero kunogona kusanganisira:

• Yakazara kuverenga ropa
• Erythrocyte sedimentation chiyero (ESR)
• MRI yemusoro
• MRA (angiography) yehuropi
• Kuongorora kwemaziso (kutonga kunze kwechirwere chemukati)
  
• CT scan yemusoro (ndiani asingakwanise kuenda kuMRI)
  
• Trigeminal reflex kuyedza (mune zvisingawanzoitika zviitiko)

Chiremba wako wekutanga wekurapa, chiremba wezvemitsipa, kana nyanzvi yezvekurwadziwa inogona kuve iri mukutarisira kwako.

Mimwe mishonga dzimwe nguva inobatsira kudzikisa marwadzo uye mwero wekurwiswa. Iyi mishonga inosanganisira:

• Mishonga yekurwisa-kubvuta, senge carbamazepine
• Tsvina inozorodza, senge baclofen
• Tricyclic antidepressants

Kurwadziswa kwenguva pfupi kwekurwadziwa kunoitika kuburikidza nekuvhiyiwa, asi inosanganiswa nenjodzi yematambudziko. Kumwe kuvhiya kunonzi microvascular decompression (MVD) kana iyo nzira yeJannetta. Munguva yekuvhiyiwa, chinhu chakaita sechipanji chakaiswa pakati petsinga neropa reropa riri kutsimbirira mutsinga.

Trigeminal nerve block (jekiseni) ine anesthetic yemuno uye steroid ndiyo yakanakisa yekurapa sarudzo yekukurumidza kubvisa marwadzo pachinomirira mishonga kuti itange kushanda.

Humwe hunyanzvi hunosanganisira kuparadza kana kucheka mativi ehutatu midzi midzi. Nzira dzinoshandiswa dzinosanganisira:

• Radiofrequency ablation (inoshandisa yakanyanya-frequency kupisa)
• Jekiseni reglycerol kana doro
• Bhaluni microcompression
• Radiosurgery (inoshandisa simba rakakura simba)

Kana bundu riri chikonzero cheTN, kuvhiyiwa kunoitwa kubvisa icho.

Unonyatsoita sei zvinoenderana nechakonzera dambudziko. Kana pasina chirwere chinokonzera dambudziko, kurapwa kunogona kupa zororo.

Mune vamwe vanhu, kurwadziwa kunoramba kuripo uye kwakanyanya.

Zvinetso zvinogona kusanganisira:

• Zvimwe zvinokanganisa mishonga inoshandiswa kurapa TN
• Zvinetso zvinokonzereswa nemaitiro, senge kurasikirwa kwekunzwa munzvimbo yakarapwa
• Kurera uremu kubva pakusadya kuti usarwadzise kurwadziwa
• Kudzivisa vamwe vanhu kana kutaura kunokonzera kurwadziwa
• Kushungurudzika, kuzviuraya
• Kukwirira kwakanyanya kwekushushikana panguva yekurwisa kwakanyanya

Bata wako mupi wehutano kana iwe uine zviratidzo zveTN, kana zviratidzo zvako zveTN zvichitowedzera.

Tic douloureux; Cranial neuralgia; Kumeso kurwadziwa - trigeminal; Chiso neuralgia; Trifacial neuralgia; Kurwadziwa kusingaperi - trigeminal; Microvascular decompression - hutatu

• Central nervous system uye yekumusoro tsinga system

Bendtsen L, Zakrzewska JM, Heinskou TB, et al. Kufambira mberi mukuongororwa, kupatsanurwa, pathophysiology, uye manejimendi yetrigeminal neuralgia. Lancet Neurol. 2020; 19 (9): 784-796. PMID: 32822636 pubmed.ncbi.nlm.nih.gov/32822636/.

Gonzales TS. Kumeso kurwadziwa uye neuromuscular hosha. Mune: Neville BW, Damm DD, Allen CM, Chi AC, eds. Oral uye Maxillofacial Pathology. 4th ed. St Louis, MO: Elsevier; 2016: chits.

Stettler BA. Ubongo uye cranial nerve kusagadzikana. Mune: Masvingo RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts uye Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chits. 95.

Waldman SD. Trigeminal neuralgia. Mune: Waldman SD, ed. Atlas yeChinhu Pain Syndromes. 4th ed. Philadelphia, PA: Elsevier; 2020: chits.