Is a distribution of the trigeminal nerve in the face region of recurrent severe paroxysmal neuralgia, trigeminal neuralgia is neurosurgery, neurology common one. 40 years of age at the onset of the majority of trigeminal neuralgia, occurs in the elderly, women in particular more than the right side of the left side of its incidence. The disease is characterized by: the trigeminal nerve distribution in the head and face area, the incidence of convulsive, arrest, lightning-like, knife-like, burning kind, stubborn, severe intolerable pain.
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Introduction of the disease clinical manifestations of the disease categories of primary medical diagnosis of trigeminal neuralgia secondary to treatment of western medicine examination tests acupuncture traditional Chinese medicine around the branch of trigeminal nerve ganglion block therapy resistance half Radiofrequency therapy treatment delay the operation of intracranial hemorrhage intracranial infection of pain facial sensory dysfunction keratitis The advantage of radiofrequency nerve avulsion half ganglion balloon compression method microvascular decompression and Gamma Knife treatment routine maintenance to prevent Several diseases with the following profile of the disease be differentiated from trigeminal neuralgia is unilateral or bilateral in the face area of trigeminal nerve pain, such as discharge,
nike air force 1, knife-like pain, neurological diseases ordinary people unbearable. High incidence, age more than 40 years of age, women more than men. Talking, brushing teeth or when the wind was blowing can lead to pain, severe pain during paroxysmal and lasted a few seconds or minutes, pain was a chronic, intermittent episodes of the same as you. Patients with trigeminal neuralgia often so afraid to wipe her face, eating, and even did not dare to swallow saliva, thus affecting the normal life and work. Therefore, this pain is known as the
the face of this disease is a chronic trigeminal nerve distribution, characterized by intermittent severe pain nervous system diseases. Trigeminal nerve is the dominant maxillofacial sensory and motor function of the first cranial nerve V, in the face there are three branches, namely the trigeminal nerve ophthalmic (first), the maxillary branch (second branch) and the mandibular branch (third branch), crack were more dominant eye, eyes and mouth split split between the feeling of mouth and masticatory muscles following exercise. Usually in clinical primary and secondary trigeminal neuralgia were divided into two. Not been able to find the cause of trigeminal neuralgia. Secondary trigeminal neuralgia, usually secondary to local infection, trauma, trigeminal nerve by a narrow hole through the bone, tumor, vascular malformation,
nike air force one, blood circulation disorders. Patients with trigeminal neuralgia secondary examination and other laboratory examinations of often abnormalities. Modern medicine diagnosis of the disease, according to the pain location, nature, seizure frequency, time and other incentives, the exclusion of brain lesions after the diagnosis is not difficult. Theory of its pathogenesis, there are theories, such as viral infection, lesion theory, ischemic theory, cervical nerve theory, genetics, allergy theory and so on. The incidence of domestic and international statistical rate was 47.8/10 and 62.6/10 million million women than men, the incidence rate can increase with age. Disease classification can be divided into primary trigeminal neuralgia (symptomatic) and secondary trigeminal neuralgia two categories, of which the more common trigeminal neuralgia. Trigeminal neuralgia is not found the exact cause of trigeminal neuralgia. May be due to hardening of the supply of blood vessels and nerve caused due to meningeal thickening may also be nerve caused by compression of bone pain caused by the narrow hole. Secondary trigeminal neuralgia: is due to tumor compression, inflammation, vascular malformations caused by trigeminal neuralgia. Different from the primary characteristics of this type of pain often has sustained, and can detect lesions of the trigeminal nerve signs adjacent structures. Primary clinical manifestations and pathogenesis of trigeminal neuralgia the cause is unclear, but most believe that the disease around the trigeminal nerve, which in the trigeminal sensory root section in half. According to microsurgery and electron microscopy, may be a small vascular malformation, deformity of bone petrous part of other factors, which cause pain attack. Sudden onset of clinical features, without any sign, mostly for one side. Attack, severe pain, such as a knife, electric shock, like a few seconds to 1 - 2 minutes, often accompanied by facial muscle twitching, tearing, salivation, facial flushing, conjunctival congestion and other symptoms, as the disease worsens, the interim period Yulai shorter, more frequent attacks, after a strong pain stimulation, patients with mental disorders to stress, never forget, causing great pain. Because the etiology and pathology of trigeminal neuralgia still unclear, Chinese medicine, is due to Treatment aims to relieve pain.
significant effect of traditional Chinese medicine therapy
pain is still a variety of ways. Can be broadly divided into non-invasive and invasive treatment. Non-invasive treatment, including western medicine, Chinese medicine, Chinese medicine acupuncture, physiotherapy and head gamma knife treatment. For short duration, less pain patients. Also be used as supplementary treatment of invasive treatment. Invasive treatments, including surgical therapy, nerve block therapy, radiofrequency therapy, gamma knife treatment. Medical diagnosis of primary trigeminal neuralgia by the diagnosis of the patient asked in detail about the patient's medical history, pain location,
nike air force one low, pain and other clinical manifestations of nature, also found that most patients by examining the subject of long-term effects of eating more lean body condition. Expression of pain onset of pain, facial oily, do not want to talk, even in intermittent speech of patients with little or do not want to talk. The patient neurological examination was normal, the trigeminal nerve senses, exercise, and corneal reflex, jaw reflex were not significantly abnormal. Some patients because of previous local treatment of facial pain caused by feeling receded, this point should be of secondary trigeminal neuralgia caused by facial hypoesthesia phase identification. X-ray photograph shows the skull base hole, the foramen ovale had no pathological changes. In summary, based on the location and nature of pain, no other neurological symptoms and signs, the diagnosis of trigeminal neuralgia usually is not difficult. Generally believed that the diagnosis of trigeminal neuralgia should have the following characteristics:
1, ###### and age: age more than 40 years of age, in both the elderly as much. More women than men, about 3:2. 2, pain location: the right than the left, the pain from the face, mouth or jaw began to spread to a point in one or more of a trigeminal nerve to the second branch, the third most common disease branch, the first person rare. Certainly not beyond the scope of their facial pain center line, not more than the trigeminal nerve distribution area. Occasional bilateral trigeminal neuralgia, accounting for 3%. 3, the nature of pain: such as cutting down, acupuncture, tearing, burning or electric shock-like severe unbearable pain, even agony. 4, the law of pain: trigeminal neuralgia attacks often without warning, and generally have regular episodes of pain. Each time from onset of pain lasted only a few seconds to 1 to 2 minutes suddenly stopped. Fewer early onset seizures, intermittent periods are long, a few minutes, several hours, with the progression of the disease, the gradual onset of frequent, intermittent period gradually shortened, and the pain has gradually increased and intense. Night pain episodes decreased. Interim period without any discomfort. 5, predisposing factors: talk, eat, wash, shaving, brushing teeth, and wind, etc. can induce episodes of pain, so patients constant state of anxiety, spiritual malaise, action cautious, even afraid to wash your face, brush your teeth, eating , speak, speak carefully, for fear of causing seizures. 6, the trigger point: the trigger point also known as Touch or pain stimuli can stimulate the onset of the trigger point. 7, facial expressions and facial changes: frequent seizures suddenly stopped talking, eating and other activities, the Department can present the side of spasm of pain that , thickened eyebrows off, conjunctival hyperemia, tearing, and salivation. Expression was nervous, anxious state. 8, the neurological examination: no abnormal signs, a small number of facial hypoesthesia. Such patients should be further asked about the history, in particular, asked whether the previous history of hypertension, and a full neurological examination, if necessary, including lumbar puncture, skull base and the internal auditory canal radiography, brain CT, MRI and other tests to help with Identification of secondary trigeminal neuralgia. Also known as secondary symptoms of trigeminal neuralgia secondary trigeminal neuralgia. Is due to intracranial and external treatment of various organic diseases cited
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from the trigeminal neuralgia. Appears similar to trigeminal neuralgia attacks in the facial expression of pain, but the pain to a lesser extent, longer duration of pain episodes, or was persistent pain, paroxysmal increase. Prevalent in the 40 years of age, young people, usually without trigger points, triggers is not obvious, a few can be found in the trigeminal nerve damage the performance of the regional and primary disease characteristics. Cerebrospinal fluid, X ray skull radiography, CT or MRI, nasopharyngeal biopsy and other help to diagnosis. Sometimes the onset of trigeminal neuralgia secondary trigeminal neuralgia very similar situation, if not pay attention to the fine performance of the early secondary lesions can easily be misdiagnosed. Facial pain caused by many diseases, regardless of extracranial disease or intracranial disease, vascular disease or neurological disease can make facial pain. A variety of diseases caused by facial pain has its common, that is able to make similar facial pain of trigeminal neuralgia with and each has its own characteristics, but, as extracranial disease and more than a change in the local tender points, intracranial changes in the local multi-with fundus changes and other cranial nerves and so on. In the differential diagnosis, should pay attention to history, careful examination of the nervous system in particular, the necessary checks and laboratory examinations, are able to make a correct diagnosis. Now easy to be confused with trigeminal neuralgia of several common diseases in the differential diagnosis are described below. (A) of glossopharyngeal neuralgia, glossopharyngeal neuralgia is seen in the glossopharyngeal nerve distribution area of the paroxysmal pain, pain location and easy to be confused with trigeminal neuralgia, pain in the third branch. Glossopharyngeal neuralgia and trigeminal neuralgia, sometimes in combination were. Diagnostic criteria for trigeminal neuralgia glossopharyngeal neuralgia incidence of lingual nerve pain location uncommon common area side of the trigeminal nerve distribution areas other than the right side of the left than the right side of the depth of deep pain in the left side of the trigger points in more than superficial In the posterior pharyngeal wall, tongue mostly in the lips, nose triggers swallowing chewing, talking, washing, shaving fear swallow the fear of eating situations lip movements and chewing, swallowing,
air force one low nike, less frequent testing painless treatment of seizure frequency of cocaine spray to the pharynx effective throat pain cocaine spray test invalid (b) the head and face pain of odontogenic to inflammation caused by many reasons, such as acute pulpitis, periodontitis, periapical inflammation,
air force one low, such as dental caries and periodontal disease often can stimulate, oppression trigeminal nerve endings, causing trigeminal nerve second, three pain, known as odontogenic trigeminal neuralgia. Careful history taking, detailed oral examination and dental X-ray photograph examination is not difficult to detect the disease caused by tooth pain. However, some dental patients, the onset of pain often radiation along the trigeminal nerve distribution area to the ipsilateral upper and lower gums, and head and face, so easy and trigeminal neuralgia facial pain caused by mixing, resulting in the latter repeatedly pulling teeth, even after removal of the affected side there is still pain in the teeth all the episodes. (C) neuropathic pain, migraine, neuropathic pain, migraine and so the word is Harris (1926) first proposed that the nature of pain in some cases, much like trigeminal neuralgia. (D) of the trigeminal nerve inflammation is a secondary branch of trigeminal neuralgia, the disease occurred in the supraorbital nerve pain is persistent, a few days after onset, some patients appear forehead shingles. A small number of patients with keratitis and ulcers can occur; pathogen is a virus; a self-limiting disease, mostly in 1 to 3 weeks recovery. Analgesic drugs, vitamins or local anesthetics, corticosteroids solution, are effective. (E) or tumor maxillary sinusitis, jaw sinus, ethmoid sinus disease can cause head and face pain. Identification should pay special attention: the nasal cavity check whether both sides of the same smooth, and inspected the tenderness of the sinuses; nasal mucus or pus with or without history; the onset of pain is not obvious, this point is more obvious on the frontal sinus cancer; Sometimes swelling of the affected side of the face; maxillary and frontal sinus light inspection; X-ray examination can help confirm the diagnosis. (F) half ganglion ganglion near the tumor and a half months at the cerebellopontine angle tumor is not uncommon, such as: auditory nerve fibers tumor, cholesteatoma, hemangioma, meningioma, or dermoid cyst, these tumors usually cause pain not very serious, unlike the pain of trigeminal neuralgia, as attack. In addition, there can also abducens nerve palsy, facial palsy, tinnitus, vertigo, hearing loss, sensory loss, trigeminal nerve branch, and other symptoms of intracranial tumors. Such as headache, vomiting, and optic disc edema. X-ray examination of skull base, petrous bone destruction Tsim District, or sometimes there is bone destruction auditory canal area. CT, X-ray contrast examination can help diagnosis. (Vii) pain in the geniculate ganglion geniculate ganglion prior to the issuance of chorda tympani nerve to issue a large shallow rock nerve to parasympathetic nerve fibers supply the lacrimal gland, lacrimal gland secretion of the manager. Middle managers of the main nerve Sheqian 2 / 3 of the eardrum membrane and external auditory canal posterior wall of taste and feeling, and some managers of fiber submandibular gland, sublingual gland and mouth, and nasal mucus gland secretion. Geniculate ganglion neuralgia is paroxysmal, but the attack deep pain in the ear, near its eyes, cheeks, nose, lips, etc. radiation, and more in the external auditory canal posterior wall of a These patients with multiple facial paralysis or facial twitching combination, and sometimes in the soft palate, the tonsils and the ear canal at the nest, the occurrence of herpes, and taste loss. Check the tests necessary trigeminal neuralgia selective examination: laboratory tests 1. Blood count, serum electrolytes general non-specific changes in blood when the disease can be a little high. 2. Glucose, immunization programs, such as abnormal CSF there were differential diagnostic significance. Imaging angiography, CT and MRI and other tests: some patients can be found in the skull base vascular malformation. Check the following items, such as abnormal, there are differential diagnostic significance. 1. EEG, fundus examination. 2. Skull radiography. 3. Fluoroscopy, electrocardiogram. Treatment of western medicine 1. Carbamazepine (carbamazepine) started 2 times a day, after a daily 3 times. Daily 0.2 ~ 0.6g, points 2 to 3 times daily, the daily maximum dose 1.2g. 24h ~ 48h after medication with analgesic effect. 2. Phenytoin (sodium phenytoin) alias Big Lundin (D1antinSodium, Phen-toin), as a white powder, odorless, taste bitter. Soluble in water, almost insoluble in ether or chloroform in the air, easy to deliquescence. Treatment of Chinese classics Chinese records and other names, such as Search through the orifices made Britain the top cause of the disease, psychological factors can also induce disease. Qi stagnation, Yu-fire a long, hot wind, wind, fire, phlegm on the disturbance caused by the folder may not stretch Qing Yang, Yang will head for all, the essence of the internal organs are the blood together in the head, all evil, wind, fire , phlegm and blood off the meridian, phlegm and blood stasis, qi stagnation and blood clotting, deter the meridians, resulting in Treatment of Shanghai exclusive name
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Shanghai Chinese family wind, cold, wet, heat and other evils, especially for , sudden bursts of pain in time from seconds to minutes, several times a day; a blowing can be caused by bursts of pain. tired or nervous attack frequently! some of the facial nerve twitch reflex or red eyes and tears. he and his mother developed side in the ancient Chinese classics were the basis of party continued in clinical research summary from, the to Ru Yang, or moving within the virtual wind induced, causing tendons Juji. Patients were mostly middle-aged women, especially over the age of 40 and more. 80% cold hands and feet, cold more. Cause of disease and their own immune system, living habits and environment are closely related. We were surprised to find in clinical: such as the Yangtze River, Zhenjiang, Jingjiang, Zhangjiagang and other places. the youngest 8 years old, maximum age of between 30 --- 85 72.3% 55 and older. the shortest month of the course, up to 34 years, an average of 6.5 years, combined with primary hypertension, coronary heart disease, high cholesterol, heart disorders, old chronic bronchitis, diabetes, cancer and so on. The average age was 59.3 years, and patients with physical weakness, wasting due to blood, blood the wind, blood virtual stagnation of qi, meridians and the incidence of resistance trapped. inferred to improve the microcirculation of the nerve, to achieve analgesia. This unique traditional Chinese medicine treatment of trigeminal neuralgia with safe, simple and very effective. usually taking 15 days from there effect, since in 20 days to start half a half a serving less significant side effects on liver and kidney of carbamazepine and other pain medicine. taking carbamazepine have side effects, and immunocompromised patients, we recommend the daily add services of high quality imported from Japan, or relieved. 44% effective: means to reduce pain, significantly reduced seizure frequency, pain duration, pain and narrowed down. 8% invalid: such patients are continuing treatment for 6 months, pain-free relief. illness recovery The patients with trigeminal neuralgia manifested in their daily lives pain is reduced, reducing the number of attacks, duration, pain intensity reduced, so that the original could not bear the pain and slow down as you can tolerate, gradually recovered to brush your teeth, wash your face, speech, normally eat, more importantly, can disable or reduce the carbamazepine. from home and abroad, and clinical response statistical results of the ! this treatment, Treatment of trigeminal neuralgia safe, simple and very effective. generally take effect 15 days from there, starting in 20 days to start half a half a serving less significant side effects on liver and kidney pain medicine such as carbamazepine .
in the 90-day treatment cycle to 660 cases for analysis: 1. at 660 cases, 10 cases were hospitalized, the youngest 26 years old, maximum 85 years old, 51 years old accounted for 72.3 %. duration of the shortest month, up to 34 years, an average of 6.5 years, 660 patients, some with primary hypertension, coronary heart disease, arrhythmia, hyperlipidemia, chronic bronchitis, diabetes, benign tumor. 660 cases of patients who have been following treatment with acupuncture, closed embedding, nerve root resection, radio frequency, taking carbamazepine, large warehouses Ding, phenytoin, an individual with over craniotomy, but not to achieve the desired effect, only a short-lived role in relieving symptoms. 2. The simple drug therapy, if treatment with traditional Chinese medicine recipe, the second day, fasting or after a meal warm for an hour, can take a month, a course of treatment. the second week begin to reduce or disable the Western carbamazepine, usually 1-3 treatments patients need to adhere to medication, some patients medication more than three courses. 3. therapeutic efficacy: markedly: All the more, the pain disappeared completely, or significantly eased. effective: pain reduced, significantly reduced seizure frequency, pain duration, pain and narrowed down. invalid: continuous medication for 6 months, pain-free relief. by this method the patient taking the third week, the pain began to ease, characterized by pain is reduced, reducing the number of episodes , duration, pain intensity reduced, so that the original could not bear the pain and slow down as you can tolerate, gradually recovered to brush your teeth, wash your face, speech, normal eating, more importantly, can disable or reduce the use of carbamazepine. markedly : 271 cases, markedly effective rate was 41% effective: 330 cases, 50% efficiency ineffective: 59 patients, 9% from the statistical inefficiency can be prompted, the superiority of treatment is obvious. Therefore, greatly reducing the suffering of the patients, reducing the financial burden of patients and shorten the duration of trigeminal neuralgia patients. original function of expelling wind cold medicine recipe scattered Tongluozhitong. with more than a dozen kinds of expensive medicine to Treatment of the wind pool, Yifeng, Shimonoseki, hand three years, Hegu. Distribution Point: the first a pain plus the sun, Yang Bai, fishing bamboo, head of peacekeeping. The first 2,3-supported pain plus the sun, four white, Shimonoseki, hearing, to warehouse, bearing slurry, Ying Hong. line re-stimulation, and needle retention. 2. acupuncture needle sticks around the trigeminal nerve supraorbital foramen, infraorbital foramen, posterior alveolar and mental foramen hole, direct needle around the trigeminal nerve branch, appears to be a branch of the distribution area of ipsilateral pain and swelling reaction of Ma, and by the rapid analgesia. held by the acupuncture technique, Twist insert system provide strong stimulus, reinforcing and reducing both yin and yang of acupuncture in patients with early supine, the way should be light in order to avoid fainting, or have fear of emotions. 3. use of acupuncture bee: bee sting bee pin contains pin fluid, significant effect on the nervous system. acupoints combined with the principle of acupuncture treatment, often will receive good results. [1] around the branch of trigeminal nerve trigeminal nerve block therapy around the branch closure is a common method of clinical treatment of trigeminal neuralgia. injection site of the main branch of the trigeminal nerve is the hole through the bone, such as the supraorbital foramen, infraorbital hole, lower alveolar holes, mental foramen, pterygopalatine hole and so on. the use of drugs, including ethanol, phenol, doxorubicin, streptomycin. trigeminal nerve pain treatment around the branch closed confined, the effect of the operator the technological level and the degree of patient's condition closely, therefore, most patients relapse six months to 2 years. trigeminal nerve peripheral branch block according to the injection site is divided into: patients supraorbital nerve block, infraorbital nerve block technique, after on the alveolar nerve block technique, maxillary nerve block technique, mental nerve block, the lower teeth and bad mandibular nerve block nerve block and surgery. half ganglion block therapy ganglion block with half the current treatment of trigeminal neuralgia has been widely used at home and abroad, over the years, the injection therapy has been shown to be effective, it does to cure trigeminal neuralgia can be permanent. However, because of injection technique is more difficult to master, mainly the accuracy of puncture operation is difficult to grasp, so , treatment with each of the technical differences and large discrepancies. foramen ovale piercing by half within the cranial cavity ganglia,
air force one high, injection of glycerol, ethanol, phenol, doxorubicin, adriamycin, nerve damage and other drugs to the first 2,3-branch of trigeminal nerve block or even all of the three, get a long block effect. for the treatment of refractory trigeminal neuralgia, maxillofacial pain, cancer pain and herpes zoster. treat indications disease 1, the injection therapy for severe and stubborn of all patients with trigeminal neuralgia, particularly in the elderly with contraindications craniotomy and chronic patients. 2, trigeminal branch involved the first 2,3, 1,2 support or all three, and by the peripheral branch block with no response. 3, stubborn facial postherpetic neuralgia. complication half ganglion block may cause some complications, mostly due to the puncture (no instrument positioning of the hand puncture) direction are not allowed into the needle too deep or damage nearby blood vessels, brain and tissue, or ethanol (safe and drug use in our hospital - medical high-purity glycerol) and into the larger dose caused subarachnoid damage. complication rate is very low. a half months after ganglion block to most of the complications can be avoided. complications include: loss of sensation within the block or abnormal; vertigo syndrome; chewing difficulties; brain damage ;. ipsilateral keratitis, corneal ulcers. injection therapy and the relationship between craniotomy can complement each other. Surgical treatment of trigeminal neuralgia in recent years has been minimal. for craniotomy patients, should be first injection, Where not successful craniotomy, or surgical treatment is not good, or relapse after surgery, injection therapy can also be received very good results. radiofrequency therapy Radiofrequency therapy is the use of high-temperature effect on ganglion , Neural stem and nerve roots and other parts, so coagulation protein denaturation, thereby blocking nerve impulse conduction. At present, radiofrequency ablation therapy in clinical practice more extensive thermal coagulation therapy works well, but more complications, is still no deaths reported. Although the recurrence rate was higher as easy to operate, repeatable, and ultimately achieve the purpose of analgesia. adverse reactions and complications of operations required to obtain pain of patients with this method. treatment should be clearly explained in the local implementation of such treatment under anesthesia has some pain, patients must obtain the understanding and cooperation, and attention to slowly heated from 60 ℃, can reduce the pain caused by a sudden high temperature. ganglion medial half of intracranial hemorrhage and carotid cavernous sinus adjacent to artery, inadvertently puncture or too deep into the foramen ovale easy to damage and bleeding, severe intracranial hematoma can form. (biopsy instrument can be totally avoided) brain damage: such as facial paresis and so on. intracranial infection aseptic prevent secondary infection of intracranial operation. special attention to prevent the repeated needle puncture puncture buccal bacteria into the oral cavity intracranial. zoster: Sunrise in the number of post-operative patient areas now, the mechanism is not clear. Local cortisone cream can be coated with methyl violet or a few days to heal. keratitis half ganglion thermal coagulation of a more serious complication is corneal reflex, paralysis can cause severe keratitis, and ultimately can lead to become blind. operation should pay attention to control the heating temperature and time, and keep track of changes in corneal reflex. corneal reflex where forfeiture has occurred, to Zhu Huanzhe glasses, protection of the cornea using the eye ointment to prevent keratitis. Some of corneal reflex take a few months after the disappearance of gradually restored. facial sensory disturbances after the majority of patients with different degrees of facial sensory impairments. In Menzel summary of the 315 cases, approximately 93.1% of patients after treatment with different degrees of facial numbness or burning sense. Thus, before treatment, patients and their families have the right to Dr. Xiang Zhuzhi understand the possible side effects of treatment may be. radiofrequency thermal coagulation of the advantages 1. surgical risk of less serious complications rarely occur; 2. available thermocouple the extent of the damage better electrode monitoring, lesion size can be effectively controlled; 3. can be electrical stimulation to locate and electrical impedance monitoring; 4. Most of radiofrequency ablation procedure can be implemented under local anesthesia; 5. the correct application , the complication rate is low; 6. necessary, repeat treatment; 7. compared with the microvascular decompression surgery, operation is relatively simple, a good analgesic effect. can eliminate most of the pain and keep touch. 8. trauma patients without hospitalization. for CT-guided radiofrequency trigeminal neuralgia surgery patients: 1. elderly and frail patients are not suitable for the treatment of microvascular decompression for trigeminal neuralgia patients; 2. microvascular decompression in patients with recurrent ; 3. long-term use higher doses of carbamazepine and / or phenytoin patients; 4. unwilling to accept the microvascular decompression in the treatment of patients; 5. a good general state of the younger patients the microvascular trigeminal nerve root can be reduced pressure operation; 6. controlling coagulation in patients with relapse after treatment: coagulation therapy can be again; 7. microvascular decompression in patients who relapse after treatment: thermal coagulation can be controlled. CT-guided radiofrequency trigeminal neuralgia surgery contraindications: 1. substandard authors, including mental disorders. 2. puncture the skin and deep tissue foci of infection by 3.. bleeding tendency or ongoing anticoagulation therapy. 4. local anesthetic allergy. 5. hyperlipidemia by low volume. 6. serious cardiovascular and cerebrovascular disease, unstable period. peripheral nerve avulsion and some experts believe that the occurrence of the dependent hardening of the arteries of the trigeminal nerve, ischemia, nutritional and metabolic disorders of nerve fibers that occurs degeneration. distal end perineural fibrosis of the blood vessels so that blood supply to further reduce pressure, increase nerve degeneration, resulting in demyelination of nerve fibers occurred surgery, to carry out the surgery, should be as much as possible avulsion of the proximal end to prevent recurrence after surgery of trigeminal neuralgia. Since the method of multi-branch trigeminal neuralgia pain or pain in the treatment of deep stretched, results are poor, so application is small. ganglion balloon compression method half balloon compression method is international, began eight years the technology for the treatment of trigeminal neuralgia. were treated with general anesthesia, tracheal intubation and controlled breathing. As the operator of skilled puncture different degrees of anesthesia time in 20 minutes to 160 minutes. so requires anesthesia terminated at any time, the patient awake as soon as possible. In the X-half months under the screen ganglion puncture. There will be 14 core needle biopsy needle biopsy of facial skin. puncture needle stopped at the oval hole, and pull the needle core, the Fogarty balloon through the needle into the half ganglion. connected with a syringe outside the balloon catheter connector into the 1 ~ 2ml of the liquid balloon swell, forming about 1 × 1.5cm of pear-shaped capsule (X ray findings under the screen), and maintain a few minutes. out of the liquid after the end of oppression, swollen balloon recovery. with the balloon and pull out the needle, oppression, stop the bleeding puncture . the whole operation were carried out under X-ray screen. surgical success rate of 90%, but relapse again after six months treatment is effective, long-term effects to be observed. microvascular decompression microvascular decompression is the first time in 1967 by Professor Jannatta proposed, such as the trigeminal nerve after Haines's relationship with microvascular anatomy of a more in-depth, are found adjacent to small blood vessels pontine trigeminal nerve root compression in 92.5% cases of trigeminal neuralgia symptoms appear. nerve causes pain, said the blood vessels as the or on the side. ② anterior inferior cerebellar artery (30%), general below the anterior inferior cerebellar artery pressure from the trigeminal nerve, but also together with the superior cerebellar artery clamping pressure on the formation of the trigeminal nerve. ③ basilar artery, with age and blood Hemodynamic effects of basilar artery bending and compression may be directed to both sides of the trigeminal nerve root, usually smaller and more bend the side of the vertebral artery. ④ the responsibility of other rare vascular still inferior cerebellar artery, vascular variations (such as the perpetuation of the trigeminal artery), transverse pontine veins, lateral veins and the basal venous plexus. Responsibility is a blood vessel can also be more support, both the arteries can also be a vein. microvascular decompression is: Under general anesthesia, in suffering from ear, the hair straight 4cm within the longitudinal incision, the skull opening, a diameter of about 2cm, under the microscope into the cerebellopontine angle, take the line of the trigeminal nerve exploration areas, all possible pressure vessels, arachnoid Article claim are Most of the patients pain disappear immediately, and retain the feel and function of the normal face, does not affect the quality of life. microvascular decompression for trigeminal neuralgia is the only way to treat the cause, and to retain the full anatomy of the trigeminal nerve Therefore, the normal trigeminal nerve function can be preserved. part of the brain stem in patients with vascular compression can eliminate high blood pressure due to the state, to achieve the purpose of cure of hypertension. As with the analgesic effect of microvascular decompression obvious, non-destructive, Vice injury less, very low recurrence rate, etc., so is the internationally recognized treatment of trigeminal neuralgia the safest, most effective way. In addition to the patients can not tolerate surgery, all other patients with trigeminal neuralgia are suitable for microvascular decompression The most common complications include hearing loss, facial hypoesthesia, but with the improvement of microsurgical techniques in neurosurgery large medical institutions, the incidence of these complications is very low, and, subject to hearing loss (incidence
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