ABSTRACT
RESUMEN: Determinar las características clínicas, pautas para el diagnóstico, tratamiento y evolución de la neuralgia del trigémino, postherpética y del nervio glosofaríngeo. Se realizó un estudio descriptivo de 119 historias clínicas de pacientes diagnosticados con neuralgia del trigémino, glosofaríngeo y postherpética tratados en el Hospital Universitario San Ignacio, registrando datos de sexo, edad, antecedentes médicos, exámenes complementarios, características clínicas, tratamientos y evolución. Se revisaron 119 historias clínicas, de las cuales 86 pertenecían a mujeres y 33 a hombres, el 84 % correspondían a neuralgias del trigémino, el 11,7 º% a post- herpética, y el 2,5% en el glosofaríngeo. El lado afectado más común fue el lado izquierdo con un 54%, las ramas más afectadas en la neuralgia del trigémino fue la maxilar y mandibular (V2- V3), en la postherpética la oftálmica (V1), la patología concomitante más frecuente hallada en el grupo fue la HTA, el tipo de dolor más frecuente fue el lancinante con un 82,4%. Los medicamentos más utilizados fueron la carbamazepina (60,5%) seguida de pregabalina (29,4%), en tratamientos quirúrgicos la radiofrecuencia fue la más empleada en un 32 %. 30 pacientes presentaron recaídas que en general fueron manejadas con aumento de las dosis de los medicamentos. Este estudio muestra una similitud con la literatura reportada, presentando más casos de neuralgia de trigémino, seguida de la post herpética y por último del glosofaríngeo. Más frecuente en mujeres, con un promedio de edad de 60 años, afectando en mayor proporción la rama mandibular y maxilar en la neuralgia de trigémino y en la postherpética la oftálmica.
ABSTRACT: To determine the clinical characteristics, guidelines for the diagnosis, treatment and evolution of trigeminal neuralgia, postherpetic neuralgia and glossopharyngeal neu- ralgia. A descriptive study of 119 clinical histories of patients diagnosed with Trigeminal Neoplasia, glossopharyngeal and postherpetic treated at the Hospital Universitario San Ignacio, recording data such as: gender, age, medical history, diagnostic exams, clinical features, branches and side of the face affected, treatments and evolution. 86 clinical records of women and 33 of men were evaluated, 100 with trigeminal neuralgia, 14 postherpetic, 3 glossopharyngeal, the most common affected side was the left side with 51%, the most affected branches in trigeminal neuralgia was the V2-V3, postherpetic V1, the most frequent antecedent of the neuralgias was the AHT, the type of pain that was more frequent was the lancinanting with 82.4%. The most commonly used medication was carbamazepine (60.5%) and pregabalin (29.4%); in surgical treatments radiofrequency was the most used in 32%; 30 patients had relapses that were generally managed with increased doses. This study shows a similarity with the reported literature, presenting more cases of trigeminal neuralgia, followed by the herpetic and finally the glossopharyngeal neuralgia, finding more cases in women than in men, with an average age of 60 years, affecting in Greater proportion the mandibular and maxillary branch in the trigeminal neuralgia and in the postherpetic ophthalmic.
ABSTRACT
Introducción: El dolor presenta elevadas tasas de prevalencia en la población con esclerosis múltiple (EM), siendo el 50% de carácter crónico y clasificándose en tipo nociceptivo, neuropático o mixto. Afecta a la calidad de vida, al sueño y a las actividades de la vida diaria. La electroterapia se presenta como una interesante alternativa o complemento en el abordaje del dolor en EM, presentando constantes innovaciones.Material y métodosEste estudio valora la eficacia de la terapia por señales electromagnéticas pulsadas y transmitidas de manera dieléctrica monopolar (SEDM) en procesos dolorosos asociados a EM mediante un ensayo clínico aleatorizado sobre 24 pacientes a los que se les medirá el dolor mediante Brief Pain Inventory, la calidad de vida con MusiQoL, la depresión con Beck y la fatiga mediante Modified Fatigue Impact Scale.ResultadosSe hallaron mejoras estadísticamente significativas en puntuaciones máximas y medias de dolor, así como en interferencia del dolor a nivel laboral, a nivel de relaciones personales, del sueño y el descanso. Las diferencias entre grupo de intervención y placebo no fueron significativas.ConclusionesEl tratamiento con SEDM podría ser efectivo para reducir el dolor en pacientes con EM, siendo necesarios más estudios para mostrar su efectividad respecto al placebo y diferenciar en qué tipología de dolor puede ser más eficaz. (AU)
Introduction: Pain is highly prevalent in patients with multiple sclerosis (MS); it is chronic in 50% of cases and is classified as nociceptive, neuropathic, or mixed-type. Pain affects quality of life, sleep, and the activities of daily living. Electrotherapy is an interesting alternative or complementary treatment in the management of pain in MS, with new innovations constantly appearing.Material and methodsThis study evaluates the effectiveness of treatment with monopolar dielectric transmission of pulsed electromagnetic fields (PEMF) for pain associated with MS. We performed a randomised, placebo-controlled clinical trial including 24 patients, who were assessed with the Brief Pain Inventory, the Multiple Sclerosis International Quality of Life questionnaire, the Beck Depression Inventory, and the Modified Fatigue Impact Scale.ResultsStatistically significant improvements were observed in maximum and mean pain scores, as well as in the impact of pain on work, personal relationships, and sleep and rest. Not significant differences were found between the treatment and placebo groups.ConclusionsTreatment with PEMF may be effective in reducing pain in patients with MS, although further research is necessary to confirm its effectiveness over placebo and to differentiate which type of pain may be more susceptible to this treatment. (AU)
Subject(s)
Humans , Activities of Daily Living , Electromagnetic Fields , Multiple Sclerosis/complications , Pain Management/methods , Pain/etiology , Quality of LifeABSTRACT
INTRODUCTION: Pain is highly prevalent in patients with multiple sclerosis (MS); it is chronic in 50% of cases and is classified as nociceptive, neuropathic, or mixed-type. Pain affects quality of life, sleep, and the activities of daily living. Electrotherapy is an interesting alternative or complementary treatment in the management of pain in MS, with new innovations constantly appearing. MATERIAL AND METHODS: This study evaluates the effectiveness of treatment with monopolar dielectric transmission of pulsed electromagnetic fields (PEMF) for pain associated with MS. We performed a randomised, placebo-controlled clinical trial including 24 patients, who were assessed with the Brief Pain Inventory, the Multiple Sclerosis International Quality of Life questionnaire, the Beck Depression Inventory, and the Modified Fatigue Impact Scale. RESULTS: Statistically significant improvements were observed in maximum and mean pain scores, as well as in the impact of pain on work, personal relationships, and sleep and rest. Not significant differences were found between the treatment and placebo groups. CONCLUSIONS: Treatment with PEMF may be effective in reducing pain in patients with MS, although further research is necessary to confirm its effectiveness over placebo and to differentiate which type of pain may be more susceptible to this treatment.
Subject(s)
Electromagnetic Fields , Multiple Sclerosis , Pain Management , Pain , Activities of Daily Living , Humans , Multiple Sclerosis/complications , Pain/etiology , Pain Management/methods , Pilot Projects , Quality of LifeABSTRACT
CASE REPORT: The case of 44 year old male patient with palpebral ptosis and trigeminal neuralgia as presenting sign of fourth ventricle ependymoma is reported. After surgical treatment, the patient developed a residual paresis of the sixth cranial nerve. DISCUSSION: Horner's syndrome occurs due to an alteration of the sympathetic innervations of the eye and adnexa. Some tumours may be the cause, in our case an ependymoma of the fourth ventricle, which onset exceptionally with blepharoptosis and involvement of the ophthalmic division of trigeminal nerve, due to the proximity of these nerve fibres at the brainstem.
