加巴喷丁与卡马西平治疗复发性三叉神经痛的临床效果分析

目的分析加巴喷丁与卡马西平治疗复发性三叉神经痛的临床效果。方法将2016年1月~2017年8月于本院进行治疗的60例复发性三叉神经痛患者作为研究对象,回顾性分析该60例患者的病历资料,按照治疗方式的不同将患者分成两组,普通组使用卡马西平进行治疗,实验组采用加巴喷丁进行治疗,对比分析两组患者的治疗效果。结果治疗后,实验组患者的VAS评分为(2.5±0.5)分,LSI-B指数为(16.5±2.1),各项指标均优于普通组(P0.05);实验组患者的治疗有效率为93.33%,不良反应发生率为3.33%,两项数据均优于普通组(P0.05)。结论加巴喷丁治疗复发性三叉神经痛的效果明显优于卡马西平,该药可有效缓解患者疼痛,且药物不良反应更少,用药安全可靠,能够显著提升患者的生活质量,应在复发性三叉神经痛的治疗中优先选用。     

Trigeminal neuralgia

Two different clinical entities, essential or secondary neuralgia, are associated with different pathologies. The pathways of CN V comprise the cervical spine, the brainstem, the root of the nerve and the three peripheral branches: V1, V2 and V3. The lesions responsible for neuralgia are neoplastic, vascular, inflammatory, malformative or post-traumatic. The examination protocol should explore the set of CN V pathways. Neurovascular compression is the main cause of essential neuralgia. It is investigated by T2-weighted inframillimetric volume. Two conditions are necessary to diagnose a neurovascular compression: localised on the root entry zone [(REZ), 2–6 mm from the emergence of the pons] and perpendicularly. In the absence of neurovascular compression, thin slices and a gadolinium injection are necessary.     

Meckel囊在经皮穿刺球囊压迫术治疗三叉神经痛中的应用解剖

目的：对Meckel 囊及其周围重要结构进行解剖学研究，并进行模拟穿刺，为提高手术成功率、减少术后 并发症提供解剖学依据。方法：采用甲醛固定的尸头标本，观察和测量Meckel 囊及其毗邻结构相关数据；将卵 圆孔分为内前（ Ⅰ）、内后（ Ⅱ）、外前（ Ⅲ）、外后（ Ⅳ）4 个象限，在直视下分别将穿刺针放置于不同象限，模拟 穿刺过程，将球囊置于Meckel 囊中，并记录穿刺结果。结果：Meckel 囊是颅后窝硬脑膜跨过岩尖在颅中窝形成 的一个裂隙样硬脑膜袋，其平均长径（12.56±1.14）mm、宽径（9.17±0.93）mm、高度（4.37±0.85）mm。囊 内包含三叉神经根、三叉神经半月节及其分支，是经皮穿刺球囊压迫术中放置球囊的目标位置，当穿刺针置于卵 圆孔Ⅱ象限时穿刺成功率为75%，高于Ⅰ象限（56%）、Ⅲ象限（25%）和Ⅳ象限（38%），差异具有统计学意义。 结论：成功穿刺Meckel 囊是经皮穿刺球囊压迫术成功的关键，熟悉Meckel 囊及其毗邻重要结构对经皮穿刺球囊 压迫术的操作至关重要，从而提高手术效果，减少术后并发症。     

川芎茶调散加减治疗三叉神经痛42例疗效分析

目的：探讨川芎茶调散加减对三又神经痛的治疗效果，以供参考。方法：选择2009年10月-2012年9月我院三叉神经痛患者84例作为研究对象，根据随机分组。A组接受卡马西平治疗，B组同时接受川芎茶调散加减治疗。连续治疗4周后评价疗效，对比两组患者总有效率的差异性。结果：对比两组总有效率发现，B组明显高于A组，差异具有统计学意义（P〈0．05）。结论：采用川芎茶调散加减辅助治疗三叉神经痛具有一定的优越性，值得推广应用。     

Pourfour du Petit Syndrome Associated With Right Eye Pressure

Pourfour du Petit (PDP) syndrome is a rare disorder characterized by ipsilateral mydriasis, eyelid retraction, and hemifacial hyperhidrosis caused by hyperactivity of the ipsilateral oculosympathetic pathway. A case is presented of PDP syndrome associated with likely ipsilateral occipital neuralgia. We review the causes and co‐morbidities and the clinical features of PDP.     

45例三叉神经痛患者体感诱发电位的分析与探讨

目的：探讨三叉神经痛患者三叉神经体感诱发电位（TSEP）的波形特征,临床价值以及手术和药物对TSEP的影响。方法：采用丹麦产DISA—2000M多导诱发肌电仪,对45例原发性三叉神经痛患者进行健侧和患侧的TSEP检查,以正常人TSEP数据作为对照,对结果进行对比分析。结果：（1）原发性三叉神经痛患者的健侧患侧比较,潜伏期N1、P3、N3及波幅N2P3、N3P4差异明显,有统计学意义（P〈0.05）。患者与健康者比较,潜伏期P1、N1、P2、N2、P3及波幅P1N1、N1P2、P2N2、N2P3、N3P4差异明显,有统计学意义（P〈0.05）。（2）原发性三叉神经痛患者TSEP高幅电位提前,潜伏期延迟。（3）手术后TSEP波形消失,药物对TSEP影响不大。结论：潜伏期N1、P3的延迟及波幅N2P3的升高,N3P4的降低可以作为原发性三叉神经痛的诊断标准。     

Anatomical basis of transgluteal pudendal nerve block

Background  The pudendal nerve may become entrapped either within the pudendal canal or near the sacrotuberous ligament resulting in a partial conduction block. The goal of the present anatomical study was to assess a new transgluteal injection technique in terms of the precise injection site and the resulting distribution of the injected agent. Materials and methods  This study was carried out using eight fresh human cadavers. An epidural needle with a removable wing was inserted and the catheter position visualized using MRI. Through the catheter 10 ml of gadolinium contrast medium was injected into three of the cadavers. A further four cadavers were injected with latex and blue pigment and the pelvi-perineal area of each then separated from the trunk for freezing before being cut into 4–8 mm thick sections with an electric bandsaw. One final cadaver was injected with a mix of gadolinium (5 ml) and latex (5 ml) and both the MRI and anatomical procedures outlined above were performed. Results  Using MRI, we clearly imaged both the site of injection, near the trunk of the pudendal nerve, and the gadolinium contrast medium in different pelvic and perineal areas and around the fascia of the obturator internus and levator ani muscle. Concerning the anatomical study, latex was observed mainly around the sacrotuberous ligament, along the obturator internus muscle and in the perineal area in contact with the dividing branches of the pudendal nerve. The mixed injection of latex and gadolinium in the pudendal canal was found with the same localization between MRI and anatomical studies. Conclusion  This easily performed technique should provide a new approach for treating perineal neuralgia via pudendal nerve block in the consultation room without the need for computed tomography.     

Effect of ultrasound-guided pulsed radiofrequency on intercostal neuralgia after lung cancer surgery: A retrospective study

This retrospective study investigated the effect of ultrasound-guided pulsed radiofrequency (UGPRF) on intercostal neuralgia (ICN) after lung cancer surgery (LCS).This retrospective observational study analyzed the outcome data of UGPRF on ICN in 80 patients with LCS. All those patients were allocated into a treatment group (n = 40) and a control group (n = 40). All patient data were collected between January 2018 and November 2019. The primary outcome was pain intensity (measured by numerical rating scale, NRS). The secondary outcomes were sleep quality (measured by Pittsburgh Sleep Quality Index, PSQI), anesthetic consumption, and treatment-related adverse events.After treatment, patients in the treatment group showed better outcomes in NRS (P < .01), PSQI (P < .01), and anesthetic consumption (P < .01), than patients in the control group. No treatment-related adverse events were documented in both groups in this study.The results of this study found that UGPRF may benefit patients for pain relief of ICN after LCS.