General aspects of trigeminal neuralgia: Guidelines for clinical approach and neurosurgical intervention
DOI:
https://doi.org/10.33448/rsd-v12i7.42782Keywords:
V pair; Trigeminal neuralgia; Anticonvulsants; Chronic pain; Hypersensitivity.Abstract
Trigeminal neuralgia is a disease that affects the V pair of cranial nerves, which are trifurcated in the face and sensitize, ipsilaterally, the corresponding hemiface. The character of excruciating pain with excruciating pain makes this pathology a relevant object of study, given its epidemiology, including extremes in suicidal outcomes. The objective of the study is to substantiate and clarify the main aspects of the pathophysiology of trigeminal neuralgia, which have not yet been fully evidenced, and from that, to organize its information in a concise and efficient content for informational support. The present work deals with an integrative literature review that used the Scielo database, as a theoretical foundation, answering the guiding question. Using the PECO research method, 146 articles were found, which were carefully selected and read. In view of this, treatment with anticonvulsants proved to be quite effective for most cases, as the pathophysiology of the disease supports the effectiveness of pharmacological treatment. However, there is a group of patients who do not respond to pharmacological interventions and need surgical intervention for therapeutic improvement. Therefore, a range of therapeutic proposals is created based on the most varied neurosurgical techniques, such as vascular decompression, radiosurgery, rhizotomy with glycerol, among others. Therefore, the option for a certain treatment depends on several aspects related to the patient in question: the composition of the multidisciplinary team, failure of non-invasive therapy and which resources will be used, seeking the complete restoration of health or substantial improvement.
References
Buckcanan Vargas, A., Mata Fuentes, M., & Fonseca Artavia, K. (2020). Neuralgia del Trigémino [Trigeminal neuralgia]. Medicina Legal de Costa Rica, 37(1), 130-137.
Chaves, J. P. G., De Oliveira, T. V. H. F., Francisco, A. N., Trintinalha, M. d. O., & Carvalho, N. V. P. (2021). Trigeminal neuralgia recurrence: a comparison of microvascular decompression and percutaneous balloon compression: a five years follow-up study [Neuralgia do trigêmeo recorrente: uma comparação entre descompressão microvascular e compressão percutânea por balão: um estudo de acompanhamento de cinco anos]. Arquivos de Neuro-Psiquiatria, 79(1), 51-55. https://doi.org/10.1590/0004-282x-anp-2020-0115.
Constanzo, F., Silva, R. S. d., de Almeida, D. B., Ferragut, M. A., Coelho Neto, M., Toledo, H. V., & Ramina, R. (2019). Gamma knife radiosurgery for trigeminal neuralgia: first case series from Latin America [Radiocirurgia por gamma knife para tratamento da neuralgia do trigêmeo: primeira série de casos na América Latina]. Arquivos de Neuro-Psiquiatria, 77(4), 232-238. https://doi.org/10.1590/0004-282x20190027.
Cruccu, G., Di Stefano, G., & Truini, A. (2020). Trigeminal Neuralgia. N Engl J Med, 383(8), 754-762. https://doi.org/10.1056/NEJMra1914484.
de la Cruz-Rodríguez, R., Sernaque-Roca, K., & Aguirre-Siancas, E. (2022). Rol De Los Canales De Sodio Voltaje Dependientes En La Fisiopatología De La Neuralgia Del Trigémino [Role Of Voltage-Dependent Sodium Channels In The Pathophysiology Of Trigeminal Neuralgia]. Revista Ecuatoriana de Neurología, 31(3), 41-46. https://doi.org/10.46997/revecuatneurol31300041.
Florêncio, D. S. F., Garcia, A. L. C., Morais, E. P. G. d., Benevides, S. D., & Alves, G. Â. d. S. (2022). Effectiveness of nonsurgical treatments for trigeminal neuralgia: an overview protocol [A efetividade dos tratamentos não cirúrgicos na neuralgia do trigêmeo: um protocolo de overview]. Revista CEFAC, 24(3). https://doi.org/10.1590/1982-0216/20222431822.
Jiménez-Olvera, M., Badillo-Rivero, P., Villanueva-Garduño, P., León-García, S. d., Pérez-Pérez, J. F., Zamorano-Toledano, G., & Morales-Aguila, M. A. (2018). Cambios en la presión intraocular en pacientes con neuralgia trigeminal sometidos a radiofrecuencia del ganglio de Gasser [Changes in intraocular pressure in patients with trigeminal neuralgia subject to radio frequency of the Gasserian ganglion]. Revista de la Sociedad Española del Dolor, 25(6), 342-348. https://doi.org/10.20986/resed.2017.3657/2017.
León-Corredor, M., Fonseca-Rubio, M. A., Velosa-Porras, J., Rodríguez-Ciodaro, A., & Barrientos-Sánchez, S. (2021). Neuralgia del Trigémino, del Glosofaríngeo y Post-herpética en Pacientes del Hospital Universitario San Ignacio (HUSI) Bogota, Colombia [Trigeminal, Glossopharyngeal and Post-Herpetic Neuralgia in Patients of the San Ignacio University Hospital (HUSI) Bogota, Colombia]. International journal of odontostomatology, 15(3), 688-693.
López-Elizalde, R., Reyes-Velasco, E., Campero, Á., Ajler, P., Cornelio-Freer, K. C., & Godínez-Rubí, M. (2019). Abordaje asterional mínimamente invasivo para descompresión microvascular en neuralgia del trigémino. Gaceta médica de México, 155, 70-78. https://doi.org/10.24875/gmm.19005130.
Machado, A. B. M., & Lucia Machado Haertel. (2014). Neuroanatomia funcional (3a ed.). Atheneu.
Marín Naranjo, R. M. (2018). El uso de toxina botulínica en el tratamiento de la neuralgia del trigémino (V par craneal). Odovtos International Journal of Dental Sciences, 20(3), 43-50. https://doi.org/10.15517/ijds.v0i0.33764.
Marín-Medina, D. S., & Gámez-Cárdenas, M. (2019). Neuralgia del trigémino: aspectos clínicos y terapéuticos [Trigeminal neuralgia: clinical and therapeutic aspects]. Acta Neurológica Colombiana, 35(4), 193-203. https://doi.org/10.22379/24224022267.
Mendes, K. D. S., Silveira, R. C. d. C. P., & Galvão, C. M. (2019). Use of the bibliographic reference manager in the selection of primary studies in integrative reviews. Texto & Contexto - Enfermagem, 28.
Molina-Olier, O., Marsiglia-Pérez, D., & Alvis-Miranda, H. (2022). Tratamiento quirúrgico de la neuralgia del trigémino en adultos [Surgical treatment of trigeminal neuralgia in adults]. Cirugía y cirujanos, 90(4), 548-555. https://doi.org/10.24875/ciru.20000772.
Robertson C. (2021). Cranial Neuralgias. Continuum (Minneapolis, Minn.), 27(3), 665–685. https://doi.org/10.1212/CON.0000000000000962.
Romero, J. G. d. A. J., Pedras, R. B. d. N., & Almeida-Leite, C. M. (2020). Botulinum toxin in pain management of trigeminal neuralgia: literature review [Toxina botulínica no tratamento da dor na neuralgia trigeminal: revisão de literatura]. BrJP, 3(4), 366-373. https://doi.org/10.5935/2595-0118.20200185.
Sanchez Arriaran, S. L., & Gonzalo Párraga, R. (2020). Descompresión microvascular para el tratamiento de la neuralgia del trigémino [Microvascular decompression for the treatment of trigeminal neuralgia]. Gaceta Médica Boliviana, 43(1), 67-73.
Standring, S., Borley, N. R., & Gray, H. (2008). Gray's anatomy: the anatomical basis of clinical practice. 40th ed., anniversary ed. [Edinburgh], Churchill Livingstone/Elsevier.
Safitri, N. E. (2023). Trigeminal Neuralgia: A Brief Review. 5(3), 8–11. https://doi.org/10.24018/ejmed.2023.5.3.1733.
Toco-Olivares, I. G., Arce-Aguilar, T. T., & Vargas-Vargas, E. (2021). Descompresión microvascular para el manejo de la neuralgia del trigemino: presentación de caso clínico y revisión de la literatura [Microvascular decompression for the handling of trigeminal neuralgia: clinical case report and literature review]. Cuadernos Hospital de Clínicas, 62(1), 46-50.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Breno Figueiredo Maia; Marcia Consentino Kronka Sosthenes
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.