I-neuralgia yeTrigeminal

I-Trigeminal neuralgia (TN) sisifo sengqondo. Kubangela ukuhlaba okanye iintlungu ezinje ngombane kwiindawo zobuso.

Intlungu ye-TN ivela kwi-nerve trigeminal. Le luvo luthwala imvakalelo yokuthinta kunye nentlungu ebusweni, emehlweni, esonweni, nasemlonyeni uye kwingqondo.

I-neuralgia ye-Trigeminal inokubangelwa:

• I-Multiple sclerosis (MS) okanye ezinye izifo ezonakalisa ukhuseleko olukhusela i-myelin yemithambo-luvo
• Uxinzelelo kwi-nerve ye-trigeminal evela kwisitya segazi esidumbileyo okanye ithumba
• Ukwenzakala kwi-nerve trigeminal, efana nokwenzakala ebusweni okanye kutyando lomlomo okanye lwesono

Rhoqo, akukho sizathu ngqo sifumanekayo. I-TN ihlala ichaphazela abantu abadala ngaphezulu kweminyaka engama-50, kodwa inokwenzeka nakweyiphi na iminyaka. Abasetyhini bachaphazeleka rhoqo kunamadoda. Xa i-TN ichaphazela abantu abangaphantsi kwe-40, ihlala ibangelwa yi-MS okanye ithumba.

Iimpawu zinokubandakanya nayiphi na kwezi zinto zilandelayo:

• Iintlungu ezibuhlungu kakhulu, ezibukhali ezinje ngombane ezihlala zihlala kwimizuzwana eliqela ukuya ngaphantsi kwemizuzu emi-2, kodwa zinokuhlala zingaguquguquki.
• Ubuhlungu buhlala kuphela kwicala elinye lobuso, uhlala ujikeleze iliso, isidlele kunye nendawo esezantsi yobuso.
• Ngokuqhelekileyo akukho lahleko okanye ukunyakaza kwendawo echaphazelekayo ebusweni.
• Intlungu inokubangelwa kukuchukumisa okanye izandi.

Ukuhlaselwa okubuhlungu kwe-neuralgia ye-trigeminal kunokubangelwa yimisebenzi eqhelekileyo, yemihla ngemihla, enje:

• Ukuthetha
• Encumile
• Ukuxubha amazinyo
• Ukuhlafuna
• Ukusela
• Ukutya
• Ukubonakaliswa kubushushu obushushu okanye obubandayo
• Ukuchukumisa ubuso
• Ukutsheva
• Umoya
• Ukufaka isicelo

Icala lasekunene lobuso liyachaphazeleka. Ngamanye amaxesha, i-TN ihamba yodwa.

Uvavanyo lwengqondo kunye ne-nervous system (neurologic) luhlala luqhelekile. Uvavanyo olwenziwe ukukhangela unobangela unokubandakanya:

• Gcwalisa ubalo lwegazi
• Izinga le-sedimentation ye-Erythrocyte (ESR)
• I-MRI yentloko
• I-MRA (i-angiography) yobuchopho
• Ukuhlolwa kwamehlo (ukukhusela isifo se-intraocular disease)
  
• Ukuvavanywa kwentloko ye-CT (ongenakuya kwi-MRI)
  
• Uvavanyo lwe-Trigeminal reflex (kwiimeko ezinqabileyo)

Ugqirha wakho wokhathalelo oluphambili, ugqirha wemithambo-luvo, okanye ingcali yentlungu inokuchaphazeleka kukhathalelo lwakho.

Amayeza athile ngamanye amaxesha anceda ukunciphisa iintlungu kunye neqondo lokuhlaselwa. La mayeza aquka:

• Amayeza okulwa nokuthimba, afana ne-carbamazepine
• Ukuphumla kwezihlunu, njengebaclofen
• I-Tricyclic yoxinzelelo

Ukuphulukiswa kwentlungu yexesha elifutshane kwenzeka ngotyando, kodwa kuyayanyaniswa nomngcipheko weengxaki. Olunye utyando lubizwa ngokuba yi-microvascular decompression (MVD) okanye inkqubo yeJannetta. Ngexesha lotyando, into efana nesiponji ibekwa phakathi kwethambo kunye nomthambo wegazi ocinezela kwimithambo-luvo.

I-block ye-nerve ye-trigeminal (inaliti) ene-anesthetic yendawo kunye ne-steroid lukhetho olufanelekileyo lokunyanga iintlungu ngokukhawuleza ngelixa ulinde ukuba amayeza aqale ukusebenza.

Ezinye iindlela zibandakanya ukutshabalalisa okanye ukusika iinxalenye zeengcambu zethambo le-trigeminal. Iindlela ezisetyenzisiweyo zibandakanya:

• Ukuchithwa kweRadiofrequency (isebenzisa ubushushu obuphezulu)
• Inaliti yeglycerol okanye utywala
• Ukunyanzeliswa kweBhaluni
• Radiosurgery (isebenzisa amandla amakhulu)

Ukuba ithumba ingunobangela we-TN, kwenziwa utyando ukuze kususwe.

Uqhuba kakuhle kangakanani kuxhomekeke kwisizathu sengxaki. Ukuba akukho sifo sibangela ingxaki, unyango lunokukunceda.

Kwabanye abantu, iintlungu zihlala zihleli kwaye zibukhali.

Iingxaki zinokubandakanya:

• Iziphumo ebezingalindelekanga zamayeza asetyenziselwa ukunyanga i-TN
• Iingxaki ezibangelwa ziinkqubo, njengokulahleka kwemvakalelo kwindawo enyangiweyo
• Ukuphulukana nobunzima bokungatyi ukuze kuthintelwe iintlungu
• Ukuphepha abanye abantu ukuba ukuthetha kubangela iintlungu
• Uxinzelelo, ukuzibulala
• Amanqanaba aphezulu oxinzelelo ngexesha lokuhlaselwa ngamandla

Nxibelelana nomboneleli wakho wezempilo ukuba uneempawu ze-TN, okanye iimpawu zakho ze-TN ziya zisiba mbi.

Tic douloureux; I-cranial neuralgia; Intlungu ebusweni - i-trigeminal; I-neuralgia yobuso; I-neuralgia ebuthathaka; Ubuhlungu obungapheliyo - i-trigeminal; Ukuncipha kwemicrovascular - trigeminal

• Inkqubo ye-nervous central kunye ne-peripheral system

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Umlingisi we-BA. Ingqondo kunye nokuphazamiseka kwentliziyo. Ku: Iindonga RM, iHockberger RS, iGausche-Hill M, ii-eds. Unyango lukaRosen oluNgxamisekileyo: iikhonsepthi kunye nokuziqhelanisa neklinikhi. Umhla we-9. IPhiladelphia, PA: Elsevier; Ngo-2018: isahluko 95.

Waldman SD. I-neuralgia yeTrigeminal. Ku: Waldman SD, ed. IiAtlas zeSyndromes zobuhlungu obuqhelekileyo. Ngomhla we-4. IPhiladelphia, PA: Elsevier; 2020: isahluko 10.