Neuralgia Trigeminal

Trigeminal neuralgia (TN) waa cilad ku dhacda neerfaha. Waxay ku keentaa mindi ama xanuun u eg shoog koronto qaybo ka mid ah wajiga.

Xanuunka TN wuxuu ka yimaadaa dareemaha trigeminal. Dareemahan ayaa xambaarsan dareenka taabashada iyo xanuunka wejiga, indhaha, sanka, iyo afka ilaa maskaxda.

Cudurka 'Trigeminal neuralgia' waxaa sababi kara:

• Cudurka 'sclerosis' (MS) ama cuduro kale oo waxyeeleeya daboolida myelin ee neerfaha
• Cadaadiska dareemaha trigeminal ee marinka dhiiga oo barara ama buro
• Dhaawac ku dhaca dareemaha trigeminal, sida dhaawac soo gaara wajiga ama qalliinka afka ama sanka

Badanaa, sabab sax ah lama helo. TN badanaa waxay ku dhacdaa dadka waaweyn ee ka weyn da'da 50 sano, laakiin waxay ku dhici kartaa da 'kasta. Haweenka ayaa inta badan saameeya ragga. Marka TN uu ku dhaco dadka da'doodu ka yar tahay 40, badanaa waxaa u sabab ah MS ama buro.

Calaamadaha waxaa ka mid noqon kara mid ka mid ah kuwan soo socda:

• Aad u xanuun badan, fallaadhaha fiiqan ee la mid ah korantada oo kale oo badanaa soconaya dhowr ilbiriqsi illaa in ka yar 2 daqiiqo, laakiin waxay noqon karaan kuwo joogto ah.
• Xanuunku badanaa waa hal dhinac oo wejiga ah, badiyaa isha, dhabanka, iyo qaybta hoose ee wejiga.
• Badanaa ma jiro lumis dareemid ama dhaqdhaqaaq qeybta wajiga taabatay.
• Xanuun waxaa sababi kara taabashada ama dhawaaqa.

Weerarada xanuunka leh ee trigeminal neuralgia waxaa sababi kara waxqabadyo caadi ah oo maalinle ah, sida:

• Hadlaya
• Dhoola caddeynaya
• Cadayashada
• Calalinta
• Cabitaanka
• Cunista
• Soo-gaadhista heer kul ama qabow
• Taabashada wajiga
• Xiirashada
• Dabayl
• Dalbashada qurxinta

Dhinaca midig ee wejiga ayaa inta badan saameeya. Xaaladaha qaarkood, TN ayaa iskood iskaga tagta.

Baadhitaanka maskaxda iyo neerfaha (neerfaha) badiyaa waa caadi. Tijaabooyinka la qaado si loo raadiyo sababta waxa ka mid noqon kara:

• Tirinta dhiigga oo dhammaystiran
• Qiyaasta qanjirka 'Erythrocyte' (ESR)
• MRI madaxa
• MRA (angiography) maskaxda
• Baadhitaanka indhaha (si meesha looga saaro cudurka xididdada ku dhaca)
  
• Baadhitaanka CT ee madaxa (oo aan mari karin MRI)
  
• Tijaabinta fal-celinta Trigeminal reflex (xaalado dhif ah)

Dhakhtarkaaga daryeelka aasaasiga ah, dhakhtarka neerfaha, ama khabiir xanuun ayaa laga yaabaa inay ku lug yeeshaan daryeelkaaga.

Daawooyinka qaarkood ayaa mararka qaarkood caawiya yareynta xanuunka iyo heerka weerarada. Daawooyinkaas waxaa ka mid ah:

• Daawooyinka ka-hortagga qalalaasaha, sida carbamazepine
• Murqaha nasteexo, sida baclofen
• Dawooyinka lidka ku ah diiqadaha ee loo yaqaan 'Tricyclic antidepressants'

Xanuun-dhimista muddada-gaaban waxay ku dhacdaa qalliin, laakiin waxay la xiriirtaa halista dhibaatooyinka. Hal qalliin ayaa loo yaqaan 'microvascular decompression' (MVD) ama nidaamka Jannetta. Inta lagu jiro qalliinka, shey u eg isbuunyo ayaa la dhex dhigayaa inta u dhexeysa neerfaha iyo xididdada dhiigga ee ku cadaadinaya dareemaha.

Xannibaadda dareemayaasha 'Trigeminal' (cirbadeynta) oo leh suuxdinta maxaliga ah iyo steroid ayaa ah ikhtiyaar daaweyn oo aad u fiican oo si dhakhso leh looga yareeyo xanuunka iyadoo la sugayo daawooyinka inay dhaqan galaan

Farsamooyinka kale waxay ku lug leeyihiin burburinta ama jarista qaybo ka mid ah xididdada dareemayaasha trigeminal. Hababka loo adeegsaday waxaa ka mid ah:

• Joojinta shucaaca shucaaca (wuxuu adeegsadaa kuleylka soo noqnoqda badan)
• Duritaanka glycerol ama aalkolo
• Qalabka buufin ee buufin
• Qalitaanka shucaaca (wuxuu isticmaalaa tamar awood sare leh)

Haddii buro ay sabab u tahay TN, qalliin ayaa loo sameeyaa si looga saaro.

Sida wanaagsan ee aad wax u qabato waxay kuxirantahay sababta dhibaatada. Haddii uusan jirin cudur keenaya dhibaatada, daaweyntu waxay bixin kartaa xoogaa gargaar ah.

Dadka qaar, xanuunku wuxuu noqdaa mid joogto ah oo daran.

Dhibaatooyinka waxaa ka mid noqon kara:

• Dhibaatooyinka ay keento daawooyinka loo isticmaalo daaweynta TN
• Dhibaatooyinka ka dhasha habsocodyada, sida dareenka oo luma meesha lagu daaweeyay
• Miisaanka oo kaa yaraada cunista si looga fogaado xanuunka kiciya
• Ka fogaanshaha dadka kale haddii hadalku kicinayo xanuun
• Niyad jab, isdil
• Heer sare oo walwal ah inta lagu jiro weerarada ba'an

La xiriir daryeel caafimaad bixiyahaaga haddii aad leedahay astaamaha TN, ama astaamahaaga TN ay ka sii darayaan.

Tic douloureux; Cudurka neerfaha ee maskaxda; Xanuunka wajiga - trigeminal; Neuralgia wajiga; Neuralgia Trifacial; Xanuun daba-dheer - trigeminal; Kala-jajabinta Microvascular - trigeminal

• Nidaamka neerfaha iyo nidaamka neerfaha ee durugsan

Bendtsen L, Zakrzewska JM, Heinskou TB, et al. Horumarka baaritaanka, kala soocida, cudurada wadnaha, iyo maareynta trigeminal neuralgia. Lancet Neurol. 2020; 19 (9): 784-796. PMID: 32822636 pubmed.ncbi.nlm.nih.gov/32822636/.

Gonzales TS. Xanuunka wajiga iyo cudurada neerfaha. Gudaha: Neville BW, Damm DD, Allen CM, Chi AC, eds. Afka iyo Maxillofacial Pathology. 4aad. St Louis, MO: Elsevier; 2016: cutubka 18.

Stettler BA. Maskaxda iyo cilladaha neerfaha cranial. Gudaha: Walls RM, Hockberger RS, Gausche-Hill M, eds. Daawada Degdega ah ee Rosen: Fikradaha iyo Tababarka Caafimaadka. 9aad. Philadelphia, PA: Elsevier; 2018: cutubka 95.

Waldman SD. Neuralgia Trigeminal. Gudaha: Waldman SD, ed. Atlas of Syndromes xanuunada caadiga ah. 4aad. Philadelphia, PA: Elsevier; 2020: cutubka 10.