未经证实:三叉神经痛(TGN)被认为是一种感觉神经病变。然而,咀嚼/说话时疼痛的报告表明咀嚼肌筋膜受累。
UNASSIGNED:为了检查超声引导干针(USGDN)的效果,使咀嚼肌筋膜触发点失活,脖子,和面部肌肉上的TGN症状。
UNASSIGNED:回顾性分析了35例TGN患者的治疗图。单用USGDN或联合三叉神经节/下颌神经脉冲射频(PRF)治疗,其次是瑜伽mudras拉伸咀嚼和面部肌肉。患者随访1-8年。结果参数是减少药物治疗,减少神经痛发作频率和数字评定量表(NRS)评分。
未经证实:23例患者(65.7%)单独接受USGDN,12例(34.3%)患者在USGDN前接受PRF治疗。与基线相比,PRF后平均(SD)NRS(5.7[1.2]vs8.8[1.6];P<.001)和神经性发作频率(47[27]vs118[70]每天发作;P<.001)显著降低,分别。在USGDN之后,平均(SD)NRS进一步显著下降至1.0(0.9)(P<.001)。单独的USGDN在NRS中产生类似的改善(基线时8.9[1.5]降低至USGDN后0.6[0.7];P<.001)。两组患者均报告USGDN后神经能发作停止。后USGDN,18/27患者完全停药,平均(SD)卡马西平剂量从基线时的716.7(260.9)mg/天显着降低至USGDN后的113.0(250.2)mg/天(P<.001)。
未经证实:USGDN对TGN的决定性缓解提示涉及咀嚼肌的神经肌痛。前瞻性,对照研究可以证实这些发现。
Trigeminal neuralgia (TGN) is considered a sensory neuropathy. However, reports of pain on chewing/speaking suggest a masticatory myofascial involvement.
To examine the effect of ultrasound-guided dry needling (USGDN), which deactivates myofascial trigger points in masticatory, neck, and facial muscles on TGN symptoms.
Charts of 35 patients treated for TGN were retrospectively reviewed. Treatment was USGDN alone or combined with trigeminal ganglion/mandibular nerve pulsed radiofrequency (PRF), followed by yoga mudras to stretch masticatory and facial muscles. Patients were followed for 1-8 years. Outcome parameters were reduction of medications with reduction in neuralgic attack frequency and Numeric Rating Scale (NRS) score.
23 patients (65.7%) received USGDN alone, 12 patients (34.3%) received PRF treatment before USGDN. A significant reduction in the mean (SD) NRS (5.7 [1.2] vs 8.8 [1.6]; P < .001) and neuralgic attack frequency (47 [27] vs 118 [70] attacks/day; P < .001) was seen after PRF compared with baseline, respectively. Following USGDN, the mean (SD) NRS further decreased significantly to 1.0 (0.9) (P < .001). USGDN alone produced a similar improvement in the NRS (8.9 [1.5] at baseline reduced to 0.6 [0.7] post-USGDN; P < .001). Patients in both groups reported a cessation in neuralgic attacks after USGDN. Post-USGDN, 18/27 patients completely discontinued medication, with the mean (SD) carbamazepine dose significantly reducing from 716.7 (260.9) mg/day at baseline to 113.0 (250.2) mg/day post-USGDN (P < .001).
Decisive relief of TGN by USGDN suggests neuromyalgia involving masticatory muscles. Prospective, controlled studies could confirm these findings.