I-trigeminal neuralgia

I-Trigeminal neuralgia (TN) ukuphazamiseka kwemizwa. Kubanga ubuhlungu bokugwazwa noma bokushaqeka obufana nogesi ezingxenyeni zobuso.

Ubuhlungu be-TN buvela emthanjeni we-trigeminal. Le nzwa ithwala imizwa yokuthinta nobuhlungu kusuka ebusweni, emehlweni, ezonweni nasemlonyeni kuya ebuchosheni.

I-trigeminal neuralgia ingabangelwa:

• I-Multiple sclerosis (MS) noma ezinye izifo ezilimaza ukuvikela i-myelin yezinzwa
• Ingcindezi kwi-nerve trigeminal evela emthanjeni wegazi ovuvukile noma isimila
• Ukulimala kwezinzwa ze-trigeminal, njengokuhlukumezeka ebusweni noma kusuka ekuhlinzekeni ngomlomo noma ngeso

Imvamisa, asitholakali isizathu esiqondile. I-TN ivame ukuthinta abantu abadala abangaphansi kweminyaka yobudala engama-50, kepha kungenzeka nganoma yisiphi isikhathi. Abesifazane bathinteka kaningi kunamadoda. Lapho i-TN ithinta abantu abangaphansi kweminyaka engama-40, imvamisa kungenxa ye-MS noma isimila.

Izimpawu zingafaka noma yikuphi okulandelayo:

• Ubuhlungu obukhulu, obukhali obufana nogesi obuvame ukuhlala kusuka kumasekhondi amaningana kuye ngaphansi kwemizuzu emi-2, kepha kungaba njalo.
• Ubuhlungu buvame kuphela ohlangothini olulodwa lobuso, imvamisa nxazonke zeso, isihlathi, nengxenye engezansi yobuso.
• Imvamisa akukho ukulahleka kwemizwa noma ukunyakaza kwengxenye ethintekile yobuso.
• Ubuhlungu bungabangelwa ukuthinta noma imisindo.

Ukuhlaselwa okubuhlungu kwe-trigeminal neuralgia kungadalwa yimisebenzi ejwayelekile, yansuku zonke, efana nale:

• Ukukhuluma
• Emomotheka
• Ukuxubha amazinyo
• Ukuhlafuna
• Ukuphuza
• Ukudla
• Ukuvezwa kokushisa okushisayo noma okubandayo
• Ukuthinta ubuso
• Ukushefa
• Umoya
• Ukufaka izimonyo

Uhlangothi lwangakwesokudla lobuso luthinteka kakhulu. Kwezinye izimo, i-TN iyazihambela yodwa.

Ukuhlolwa kobuchopho kanye nesistimu yezinzwa (i-neurologic) kuvame ukujwayelekile. Ukuhlolwa okwenziwa ukubheka imbangela kungafaka:

• Qedela ukubalwa kwegazi
• Izinga le-sedimentation ye-Erythrocyte (ESR)
• I-MRI yekhanda
• I-MRA (angiography) yobuchopho
• Ukuhlolwa kwamehlo (ukukhipha isifo se-intraocular)
  
• I-CT scan yekhanda (ongakwazi ukungena ku-MRI)
  
• Ukuhlolwa kwe-Trigeminal reflex (ezimweni ezingavamile)

Udokotela wakho oyinhloko wokunakekelwa, isazi sezinzwa, noma uchwepheshe wezobuhlungu angabandakanyeka ekunakekelweni kwakho.

Imithi ethile kwesinye isikhathi isiza ukunciphisa izinhlungu nezinga lokuhlaselwa. Le mithi ihlanganisa:

• Imithi elwa nokubanjwa, njenge-carbamazepine
• Ukuphumula kwemisipha, njenge-baclofen
• I-Tricyclic antidepressants

Ukuphumula kobuhlungu besikhathi esifushane kwenzeka ngokuhlinzwa, kepha kuhlotshaniswa nobungozi bezinkinga. Ukuhlinzwa okukodwa kubizwa ngokuthi yi-microvascular decompression (MVD) noma inqubo yeJannetta. Ngesikhathi sokuhlinzwa, kufakwa into efana nesipanji phakathi kwenzwa nomthambo wegazi ocindezela inzwa.

I-Trigeminal nerve block (injection) ene-anesthetic yendawo ne-steroid kuyindlela enhle kakhulu yokwelashwa yokudambisa izinhlungu ngokushesha ngenkathi kulindwe ukuthi imithi iqale ukusebenza.

Amanye amasu abandakanya ukubhubhisa noma ukusika izingxenye zempande ye-trigeminal nerve. Izindlela ezisetshenzisiwe zifaka:

• I-Radiofrequency ablation (isebenzisa ukushisa okuvama kakhulu)
• Ukujova i-glycerol noma utshwala
• Ukuncipha kweBhaluni
• I-Radiosurgery (isebenzisa amandla amakhulu wamandla)

Uma isimila siyimbangela ye-TN, kwenziwa ukuhlinzwa ukuze kususwe.

Ukwenza kahle kangakanani kuya ngesizathu senkinga. Uma singekho isifo esidala inkinga, ukwelashwa kunganikeza ukukhululeka okuthile.

Kwabanye abantu, ubuhlungu buba njalo futhi bube nzima.

Izinkinga zingafaka:

• Imiphumela emibi yemithi esetshenziselwa ukwelapha i-TN
• Izinkinga ezibangelwa izinqubo, njengokulahlekelwa umuzwa endaweni ephethwe
• Ukwehla kwesisindo ngokungadli ukugwema ukubangela ubuhlungu
• Ukugwema abanye abantu uma ukukhuluma kubangela ubuhlungu
• Ukudana, ukuzibulala
• Izinga eliphakeme lokukhathazeka ngesikhathi sokuhlaselwa okunamandla

Xhumana nomhlinzeki wakho wezokunakekelwa kwezempilo uma unezimpawu ze-TN, noma izimpawu zakho ze-TN ziba zimbi kakhulu.

UTic douloureux; I-cranial neuralgia; Ubuhlungu ebusweni - i-trigeminal; I-neuralgia yobuso; I-neuralgia encane; Ubuhlungu obungapheli - i-trigeminal; Ukuncipha kwe-Microvascular - trigeminal

• Isistimu yezinzwa emaphakathi nesistimu yezinzwa ezungezayo

UBendtsen L, Zakrzewska JM, Heinskou TB, et al. Intuthuko yokuxilongwa, ukuhlukaniswa, i-pathophysiology, kanye nokuphathwa kwe-trigeminal neuralgia. ILancet Neurol. 2020; 19 (9): 784-796. I-PMID: 32822636 pubmed.ncbi.nlm.nih.gov/32822636/.

IGonzales TS. Ubuhlungu ebusweni nezifo ze-neuromuscular. Ku: Neville BW, Damm DD, Allen CM, Chi AC, eds. I-Oral neMaxillofacial Pathology. Umhla wesi-4. ISt Louis, MO: Elsevier; 2016: isahluko 18.

I-Stettler BA. Ukuphazamiseka kwengqondo nobuchopho be-cranial. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 95.

I-Waldman SD. I-trigeminal neuralgia. Ku: Waldman SD, ed. I-Atlas yama-Syndromes obuhlungu obujwayelekile. Umhla wesi-4. IPhiladelphia, PA: Elsevier; 2020: isahluko 10.