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病因不明的三叉神经痛称为特发性三叉神经痛;因肿瘤、失症、血管病、牙病、副鼻窦炎或多发性硬化等所致的三叉神经痛称为症状性三叉神经痛.在日常诊疗中大多为前者.药物疗法(一)抗痉挛药1.酰胺咪嗪(Carbamazepine, Tegretol)对三叉神经痛特效,为今日的首选药物.1962年Blom首先报告对三叉神经痛有效.第二年他报告40例,每日平均用600～800mg,最高达1200mg,36例(90%)于24小时内剧痛发作消失,经6个月以上的随访在27例中仍有22例(81.5%)未见复发,强调了本药的有效性和速效性.此后这方面的报告很多,平均70-80%的病例有效,用药后出现效果快,停药后则较多复发.这可能与消化道吸收不良,血中浓度不足,或诊断上的错误等有关.剂量:开始给予100-200mg/日,逐渐增至400-800mg/日而维持之,有时可达1200mg/日,若已用至1600mg/日而无效时则应考虑其他方法.
Trigeminal neuralgia of unknown etiology is called idiopathic trigeminal neuralgia; trigeminal neuralgia due to cancer, ailment, vascular disease, dental disease, paranasal sinusitis or multiple sclerosis is called symptomatic trigeminal neuralgia. Most of the day-to-day treatment of the former.Medical therapy (A) anti-spasticity drug 1.Malbamazepine (Tegretol) on the trigeminal neuralgia, the drug of choice for the first time in 1962 Blom first report of trigeminal neuralgia effective second In 2004, he reported 40 cases with a daily average of 600 ~ 800mg, up to 1200mg and 36 cases (90%) disappeared within 24 hours. After more than 6 months of follow-up, there were still 22 cases (81.5% %) No recurrence, emphasizing the effectiveness and quick-acting of the drug. Since then there are many reports in this area, an average of 70-80% of cases effective, fasting effect after treatment, and more relapse after stopping .This may be related to Digestive tract malabsorption, lack of blood concentration, or diagnostic errors, etc. Dosage: Start to give 100-200mg / day, and gradually increased to 400-800mg / day and maintained, and sometimes up to 1200mg / day, if used To 1600mg / day and invalid, you should consider other methods.