Ubuhlungu Be-Trigeminal
Uhlolojikelele
I-Trigeminal neuralgia (i-try-JEM-ih-nul nu-RAL-juh) iyisimo esibangela ubuhlungu obukhulu obukhulu njengokushaqeka kombane ohlangothini olulodwa lobuso. Ithonya inzwa ye-trigeminal, ethwala izimpawu ezivela ebusweni ziye ebuchosheni. Ngisho nokubamba okulula kokuhlamba amazinyo noma ukufaka i-makeup kungase kubangele ubuhlungu obukhulu. I-Trigeminal neuralgia ingaphila isikhathi eside. Yaziwa njengesimo sobuhlungu obuhlala njalo.
Abantu abane-trigeminal neuralgia bangase baqale bahlangabezane nezikhathi ezimfushane, ezilula zokubhlungu. Kodwa isimo singaba sibi kakhulu, sibangele izikhathi ezinde zokubhlungu ezenzeka kaningi. Kuvamile kakhulu kwabesifazane nabantu abadala kuno-50.
Kodwa i-trigeminal neuralgia, eyaziwa nangokuthi yi-tic douloureux, ayisho ukuthi uphila ukuphila kobuhlungu. Ngokuvamile ingaphathwa ngokwelashwa.
Izimpawu
Amasimptomu e-trigeminal neuralgia angafaka phakathi enye noma ngaphezulu kwalemizamo: Izigameko zokudabuka okukhulu noma ukuhlunguluza ubuhlungu obungase buzwakale njengokuqhuma kombane. Izigameko eziqubukelayo zobuhlungu noma ubuhlungu obuvusa ukushaya ubuso, ukukoma, ukukhuluma noma ukukhahlela amazinyo. Izigameko zobuhlungu ezihlala kusuka emizuzwini embalwa kuya kwimizuzu eminingana. Ubuhlungu obuvela ngezikhathi zokubamba ubuso. Izigameko zobuhlungu ezihlala izinsuku, amasonto, izinyanga noma isikhathi eside. Abanye abantu banezikhathi lapho bengaboni lutho ubuhlungu. Ubuhlungu ezindaweni eziphikiswe yi-trigeminal nerve. Lezi zindawo zifaka phakathi i-cheek, i-jaw, amazinyo, i-gums noma izindebe. Ngokuncane, iso ne-forehead kungenzeka lithonyeke. Ubuhlungu ohlangothini olulodwa lobuso ngesikhathi esisodwa. Ubuhlungu obuqondiswe endaweni eyodwa. Noma ubuhlungu bungase buhanjiswe ngendlela ebanzi. Ubuhlungu obungavamile ukwenzeka ngesikhathi sokulala. Izigameko zobuhlungu eziyanda kakhulu futhi zibe nzima ngokuhamba kwesikhathi. Bheka ochwepheshe bakho bezempilo uma uhlangabezana nobuhlungu ebusweni bakho, ikakhulukazi uma buhlala isikhathi eside noma buyabuya ngemuva kokushiya. Thola futhi ukunakekelwa kwezokwelapha uma unebuhlungu obuhlala njalo obungapheli ngemithi ebuhlungu oyithengayo eshalofini.
Isikhathi sokubona udokotela
Bona udokotela wakho uma uhlushwa ubuhlungu ebusweni, ikakhulu uma buhlala isikhathi eside noma buyabuya ngemva kokuba buyeke. Thola nokunakekelwa kwezokwelapha uma uhlushwa ubuhlungu obuhlala njalo obungapheli ngemithi yokuhlunguza oyithengayo esitolo.
Izimbangela
ENge-neuralgia ye-trigeminal, umsebenzi we-nerve ye-trigeminal uyaphazanyiswa. Ukuthintana phakathi kwesithombo segazi ne-nerve ye-trigeminal emazantsi obuchopho kuvame ukubangela ubuhlungu. Isicubu segazi singaba yinyama okanye i-vein. Lolu thintano lubangela uxinzelelo kwi-nerve futhi aluvumeli ukuba isebenze njengokujwayelekile. Kodwa-ke, ngenkathi ukucindezelwa yisithombo segazi kuyimbangela evamile, kunezizathu eziningi ezingaba khona. I-multiple sclerosis noma isimo esifanayo esonakalisa i-myelin sheath evikela ama-nerve athile singabangela i-neuralgia ye-trigeminal. Ukuqina komdlavuza ngokumelene ne-nerve ye-trigeminal nakho kungabangela le simo. Abanye abantu bangase babe ne-neuralgia ye-trigeminal ngenxa yesifo sokuqina noma ukulimala kobuso. Ukulimala kwe-nerve ngenxa yokuthi ukucutshungulwa nakho kungabangela i-neuralgia ye-trigeminal. Izici eziningi zingase zibangele ubuhlungu be-neuralgia ye-trigeminal, okuhlanganisa: Ukuhlanza. Ukubamba ubuso bakho. Ukudla. Ukuphuza. Ukubrushisa amazinyo akho. Ukukhuluma. Ukuzibeka i-makeup. Umoya olukhanyayo oluphezulu ebusweni bakho. Ukuhleka. Ukugeza ubuso bakho.
Izici eziyingozi
Ucwaningo luthole ukuthi izici ezithile zibeka abantu engozini enkulu yokuthola i-trigeminal neuralgia, okuhlanganisa:
- Ubulili. Abesifazane banesilinganiso esiphezulu sokufumanisa i-trigeminal neuralgia kunamadoda.
- Ubudala. I-Trigeminal neuralgia ivame kakhulu kubantu abangaphezu kweminyaka engama-50.
- Izimo ezithile. Ngokwesibonelo, ukuqina kwegazi kuyisici esikhulayo se-trigeminal neuralgia. Ngaphezu kwalokho, abantu abane-multiple sclerosis banengozi enkulu yokuthola i-trigeminal neuralgia.
Ukuxilongwa
Uchwepheshe wakho wezempilo uthola i-trigeminal neuralgia ikakhulu ngokusekelwe ekuchazeni kwakho ubuhlungu, okuhlanganisa:
- Uhlobo. Ubuhlungu obuhambisana ne-trigeminal neuralgia buyashesha, buzwakala njengokuqhuma kombane futhi bufushane.
- Indawo. Izingxenye zobuso bakho ezithintekayo ngubuhlungu zingatshela uchwepheshe wakho wezempilo uma inzwa ye-trigeminal ihilelekile.
- Izici ezikhuthazayo. Ukudla, ukukhuluma, ukuthinta okukhanyayo kobuso bakho noma ngisho nomoya opholile kungaletha ubuhlungu.
Uchwepheshe wakho wezempilo angenza amavivinyo ukuthola i-trigeminal neuralgia. Amavivinyo angasiza futhi ukuthola izimbangela zesimo. Angafaka:
- Magnetic resonance imaging (MRI). Ungadinga i-MRI ukubuka izimbangela ezingaba khona ze-trigeminal neuralgia. I-MRI ingabonisa izimpawu ze-multiple sclerosis noma i-tumor. Ngezinye izikhathi i-dye isetshenziswa esithombeni segazi ukubuka imithambo yegazi kanye nezinzwa ukuze kuboniswe ukugeleza kwegazi.
Ubuhlungu bakho ebusweni bungabangelwa izimo eziningi ezahlukene, ngakho-ke ukuxilongwa okuchane kukunzima. Uchwepheshe wakho wezempilo angase futhi a-ode amavivinyo amanye ukukhipha ezinye izimo.
Ukwelashwa
Ukwelapha i-neuralgia ye-trigeminal kuqala ngokuvamile ngemithi, futhi abanye abantu abadingi ukwelashwa okuengeziwe. Noma kunjalo, ngokuhamba kwesikhathi, abanye abantu abanesimo bangase bayeke ukuphendula emithini, noma bangase babe nezindlela ezingathandeki. Kulabo bantu, ukugonywa noma ukuhlinzwa kunikeza ezinye izinketho zokwelapha i-neuralgia ye-trigeminal. Uma isimo sakho sibangelwa enye into, njenge-multiple sclerosis, udinga ukwelashwa kwesimo esiyimbangela. Ukuze welaphe i-neuralgia ye-trigeminal, ochwepheshe bezempilo bancoma imithi ukunciphisa noma ukuvimba izimpawu zobuhlungu ezithunyelwa ebuchosheni bakho.
- Imithi yokulwa nokuhlwitha. Ochwepheshe bezempilo bavame ukuncoma i-carbamazepine (Tegretol, Carbatrol, nabanye) ye-neuralgia ye-trigeminal. Kubonwe ukuthi isebenza ekwelapheni isimo. Ezinye imithi yokulwa nokuhlwitha engase isetshenziswe ihlanganisa i-oxcarbazepine (Trileptal, Oxtellar XR), i-lamotrigine (Lamictal), ne-phenytoin (Dilantin, Phenytek, Cerebyx). Ezinye imithi engase isetshenziswe ihlanganisa i-topiramate (Qudexy XR, Topamax, nabanye), i-pregabalin (Lyrica) ne-gabapentin (Neurontin, Gralise, Horizant). Uma imithi yokulwa nokuhlwitha oyisebenzisayo ingasasebenzi kahle, ochwepheshe bezempilo bangase bakhulise umthamo noma bashintshe kwenye into. Imiphumela emibi yemithi yokulwa nokuhlwitha ingase ihlanganise ukukhungatheka, ukudideka, ukulala kakhulu nokuphefumula. Futhi, i-carbamazepine ingase ibe nomphumela omubi kubantu abathile, ikakhulu kulabo abavela e-Asia. Ukuhlolwa kwe-genetic kungase kunconywe ngaphambi kokuba uqale i-carbamazepine.
- Imithi yokululamisa izicubu. Imithi yokululamisa izicubu njenge-baclofen (Gablofen, Fleqsuvy, nabanye) ingase isetshenziswe yodwa noma ngokuhlanganiswa ne-carbamazepine. Imiphumela emibi ingase ihlanganise ukudideka, ukuphefumula nokulala kakhulu.
- Ukugonywa kwe-Botox. Izifundo ezincane zibonise ukuthi ukugonywa kwe-onabotulinumtoxinA (Botox) kungase kunciphisa ubuhlungu obuvela kwi-neuralgia ye-trigeminal kubantu abangasisizi emithini. Noma kunjalo, ucwaningo olwengeziwe luyafaneleka ngaphambi kokuba lokhu kwelashwa kusetshenziswe kabanzi kule simo. Imithi yokulwa nokuhlwitha. Ochwepheshe bezempilo bavame ukuncoma i-carbamazepine (Tegretol, Carbatrol, nabanye) ye-neuralgia ye-trigeminal. Kubonwe ukuthi isebenza ekwelapheni isimo. Ezinye imithi yokulwa nokuhlwitha engase isetshenziswe ihlanganisa i-oxcarbazepine (Trileptal, Oxtellar XR), i-lamotrigine (Lamictal), ne-phenytoin (Dilantin, Phenytek, Cerebyx). Ezinye imithi engase isetshenziswe ihlanganisa i-topiramate (Qudexy XR, Topamax, nabanye), i-pregabalin (Lyrica) ne-gabapentin (Neurontin, Gralise, Horizant). Uma imithi yokulwa nokuhlwitha oyisebenzisayo ingasasebenzi kahle, ochwepheshe bezempilo bangase bakhulise umthamo noma bashintshe kwenye into. Imiphumela emibi yemithi yokulwa nokuhlwitha ingase ihlanganise ukukhungatheka, ukudideka, ukulala kakhulu nokuphefumula. Futhi, i-carbamazepine ingase ibe nomphumela omubi kubantu abathile, ikakhulu kulabo abavela e-Asia. Ukuhlolwa kwe-genetic kungase kunconywe ngaphambi kokuba uqale i-carbamazepine. Izinketho zokuhinzwa ze-neuralgia ye-trigeminal zihlanganisa:
- Ukuhlinzwa kwe-stereotactic radiosurgery yobuchopho, okuthiwa yi-Gamma Knife. Kule nqubo, udokotela oqeqeshwe kahle uqondisa umthamo ogxilile wokushisa esukadi le-trigeminal nerve. Ukushisa konakalisa i-trigeminal nerve ukunciphisa noma ukuyeka ubuhlungu. Ukuphumula ebuhlungwini kwenzeka kancane kancane futhi kungathatha inyanga. Ukuhlinzwa kwe-stereotactic radiosurgery yobuchopho kuphumelela ekumiseni ubuhlungu kubantu abaningi. Kodwa njengazo zonke izinqubo, kunengozi yokuthi ubuhlungu bungabuya, ngokuvamile phakathi kweminyaka engu-3 kuya kwengu-5. Uma ubuhlungu buyabuya, inqubo ingaphindwa noma ungase ube nenye inqubo. Ukungabi namandla ebusweni yimiphumela emibi evamile, futhi ingase ibonakale ngezinyanga noma eminyakeni ngemuva kwenqubo. Ukuhlinzwa kwe-stereotactic radiosurgery yobuchopho, okuthiwa yi-Gamma Knife. Kule nqubo, udokotela oqeqeshwe kahle uqondisa umthamo ogxilile wokushisa esukadi le-trigeminal nerve. Ukushisa konakalisa i-trigeminal nerve ukunciphisa noma ukuyeka ubuhlungu. Ukuphumula ebuhlungwini kwenzeka kancane kancane futhi kungathatha inyanga. Ukuhlinzwa kwe-stereotactic radiosurgery yobuchopho kuphumelela ekumiseni ubuhlungu kubantu abaningi. Kodwa njengazo zonke izinqubo, kunengozi yokuthi ubuhlungu bungabuya, ngokuvamile phakathi kweminyaka engu-3 kuya kwengu-5. Uma ubuhlungu buyabuya, inqubo ingaphindwa noma ungase ube nenye inqubo. Ukungabi namandla ebusweni yimiphumela emibi evamile, futhi ingase ibonakale ngezinyanga noma eminyakeni ngemuva kwenqubo. Ezinye izinqubo zingase zisetshenziswe ukwelapha i-neuralgia ye-trigeminal, njenge-rhizotomy. Kwi-rhizotomy, udokotela wakho uqothula ucingo lwezinzwa ukunciphisa ubuhlungu. Lokhu kubangela ukungabi namandla ebusweni. Izinhlobo ze-rhizotomy zihlanganisa:
- Ukugonywa kwe-glycerol. I-needle ehamba ebusweni iye ekhefini esisekelweni lengqondo inikeza imithi ukunciphisa ubuhlungu. I-needle iqondiswa esikhwameni esincane se-spinal fluid esizungezile indawo lapho i-trigeminal nerve ihlukaniswa khona ibe yizigaba ezintathu. Khona-ke kunikezwa inani elincane le-glycerol ehlanzekile. I-glycerol yonakalisa i-trigeminal nerve futhi ivimba izimpawu zobuhlungu. Lolu hlelo luhlala luqeda ubuhlungu. Noma kunjalo, ubuhlungu buyabuya kubantu abathile. Abantu abaningi baba nokungabi namandla ebusweni noma ukukhungatheka ngemuva kokugonywa kwe-glycerol.
- Ukuhlinzwa kwe-radiofrequency thermal lesioning. Lolu hlelo luqothula ngokukhetha ucingo lwezinzwa oluhlobene nobuhlungu. Ngenkathi ulele, udokotela wakho ufake i-needle ehlongozwayo ebusweni bakho. Udokotela wakho uqondisa i-needle engxenyeni ye-trigeminal nerve ehamba ngekhefini esisekelweni lengqondo yakho. Uma i-needle isibekwe, udokotela wakho uyakuvusa okwesikhashana. Udokotela wakho ufake i-electrode nge-needle bese uthumela umfula omncane wama-electrical ngaphezulu kwe-electrode. Ubuzwa ukuthi uthi nini futhi kuphi lapho uzizwa ukhungatheka. Uma udokotela wakho ethola ingxenye yenerve ehilelekile ebuhlungwini bakho, ubuyela ekuphumuleni. Khona-ke i-electrode ishisa kuze kube yilapho yonakalisa ucingo lwezinzwa, idala indawo yokulimaza eyaziwa ngokuthi yi-lesion. Uma i-lesion ingayikhiphi ubuhlungu bakho, udokotela wakho angase adale ezinye izindawo zokulimaza. Ukuhlinzwa kwe-radiofrequency thermal lesioning ngokuvamile kuholela ekungabikho kwamandla ebusweni okwesikhashana ngemuva kwenqubo. Ubuhlungu bungabuya ngemuva kweminyaka engu-3 kuya kwengu-4. Ukugonywa kwe-glycerol. I-needle ehamba ebusweni iye ekhefini esisekelweni lengqondo inikeza imithi ukunciphisa ubuhlungu. I-needle iqondiswa esikhwameni esincane se-spinal fluid esizungezile indawo lapho i-trigeminal nerve ihlukaniswa khona ibe yizigaba ezintathu. Khona-ke kunikezwa inani elincane le-glycerol ehlanzekile. I-glycerol yonakalisa i-trigeminal nerve futhi ivimba izimpawu zobuhlungu. Lolu hlelo luhlala luqeda ubuhlungu. Noma kunjalo, ubuhlungu buyabuya kubantu abathile. Abantu abaningi baba nokungabi namandla ebusweni noma ukukhungatheka ngemuva kokugonywa kwe-glycerol. Ukuhlinzwa kwe-radiofrequency thermal lesioning. Lolu hlelo luqothula ngokukhetha ucingo lwezinzwa oluhlobene nobuhlungu. Ngenkathi ulele, udokotela wakho ufake i-needle ehlongozwayo ebusweni bakho. Udokotela wakho uqondisa i-needle engxenyeni ye-trigeminal nerve ehamba ngekhefini esisekelweni lengqondo yakho. Uma i-needle isibekwe, udokotela wakho uyakuvusa okwesikhashana. Udokotela wakho ufake i-electrode nge-needle bese uthumela umfula omncane wama-electrical ngaphezulu kwe-electrode. Ubuzwa ukuthi uthi nini futhi kuphi lapho uzizwa ukhungatheka. Uma udokotela wakho ethola ingxenye yenerve ehilelekile ebuhlungwini bakho, ubuyela ekuphumuleni. Khona-ke i-electrode ishisa kuze kube yilapho yonakalisa ucingo lwezinzwa, idala indawo yokulimaza eyaziwa ngokuthi yi-lesion. Uma i-lesion ingayikhiphi ubuhlungu bakho, udokotela wakho angase adale ezinye izindawo zokulimaza. Ukuhlinzwa kwe-radiofrequency thermal lesioning ngokuvamile kuholela ekungabikho kwamandla ebusweni okwesikhashana ngemuva kwenqubo. Ubuhlungu bungabuya ngemuva kweminyaka engu-3 kuya kwengu-4. sixhumanisi sokukhansela i-imeyili. Ukuphathwa kwe-neuralgia ye-trigeminal okungenjalo akukafundwa kahle njengemithi noma izinqubo zokuhinzwa. Ngokuvamile kunobuncinci ubufakazi bokuthi basetshenziswa. Noma kunjalo, abanye abantu bathole ukuthuthuka ngokwelashwa okunjengoku-acupuncture, i-biofeedback, i-chiropractic, kanye ne-vitamin noma ukwelashwa kokudla. Qiniseka ukuthi ukhulumisana nodokotela wakho ngaphambi kokuzame ukwelashwa okungenjalo ngoba kungase kuhlangane nezinye izindlela zakho zokwelapha. Ukuphila ne-neuralgia ye-trigeminal kungase kube nzima. Lesi sifo singase sihlanganise ukusebenzisana kwakho nabangane nomndeni, ukukhiqiza kwakho emsebenzini, kanye nekhwalithi yempilo yakho iyonke. Ungase uthole isikhuthazo nokuqonda eqenjini lokusekela. Amalungu eqembu ngokuvamile ayazazi izindlela zokwelapha zakamuva futhi athanda ukwabelana ngamava abo. Uma unesithakazelo, udokotela wakho angase akwazi ukuncoma iqembu endaweni yakho.
Umshwana wokuzihlangula: I-August iyinkundla yolwazi lwezempilo futhi izimpendulo zayo azihlanganisi iseluleko sezokwelapha. Njalo thintana nochwepheshe bezokwelapha onelayisensi eduze nawe ngaphambi kokwenza noma yiluphi ushintsho.