actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.29413/ABS.2021-6.4.11actabiomedica-2980Research ArticleНЕВРОЛОГИЯ И НЕЙРОХИРУРГИЯNEUROLOGY AND NEUROSURGERYИсторические аспекты проблемы лечения невралгии тройничного нерва и роль нейрохирургических методов в её решении (обзор литературы)Historical aspects of the problem of treatment of trigeminal neuralgia and the role of neurosurgical methods in its solution (literature review)https://orcid.org/0000-0002-6910-1729ЖуркинА. Н.ZhurkinA. N.

 аспирант

664003, г. Иркутск, ул. Борцов Революции, 1, Россия 

 Postgraduate

Bortsov Revolyutsii str. 1, Irkutsk 664003, Russian Federation 

cpike@mail.ruhttps://orcid.org/0000-0002-2547-7812СеменовА. В.SemenovA. V.

 кандидат медицинских наук, старший научный сотрудник научно-клинического отдела нейрохирургии

664003, г. Иркутск, ул. Борцов Революции, 1, Россия 

 Cand. Sc. (Med.), Senior Research Officer at the Clinical Research Department of Neurosurgery

Bortsov Revolyutsii str. 1, Irkutsk 664003, Russian Federation 

7enov2001@mail.ruhttps://orcid.org/0000-0002-9008-6383СороковиковВ. А.SorokovikovV. A.

 доктор медицинский наук, профессор, директор

664003, г. Иркутск, ул. Борцов Революции, 1, Россия 

 Dr. Sc. (Med.), Professor, Director

Bortsov Revolyutsii str. 1, Irkutsk 664003, Russian Federation 

vasorokovikov@mail.ruhttps://orcid.org/0000-0001-7920-5997БартульН. В.BartulN. V.

 врач-невролог

664011, г. Иркутск, ул. Тимирязева, 31, Россия 

 Neurologist

 Timiryazeva str. 31, Irkutsk 664011, Russian Federation 

Natali-shell@list.ruФГБНУ «Иркутский научный центр хирургии и травматологии»Irkutsk Scientific Centre of Surgery and TraumatologyОГБУЗ «Иркутская городская клиническая больница № 3»Irkutsk City Clinical Hospital N 320211210202164123136Copyright © Журкин А.Н., Семенов А.В., Сороковиков В.А., Бартуль Н.В., 20212021Журкин А.Н., Семенов А.В., Сороковиков В.А., Бартуль Н.В.Zhurkin A.N., Semenov A.V., Sorokovikov V.A., Bartul N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/2980

Тройничный нерв является смешанным пятым черепно-мозговым нервом, который обладает двигательным и чувствительным компонентами. Чувствительный компонент принимает в центральную нервную систему соместезическую информацию от кожи и слизистых оболочек лица, а двигательный отвечает за иннервацию жевательной мускулатуры. Одним из проявления патологии тройничного нерва является болевой синдром. Невралгия тройничного нерва (НТН) занимает основное место среди неврогенных болевых синдромов в области лица, отличается тяжёлым течением и недостаточной эффективностью консервативных методов лечения. По данным Всемирной организации здравоохранения, распространённость НТН в разных странах составляет 2–5 случаев на 100 тыс. населения в год. Выделяют следующие виды невралгий тройничного нерва: идиопатическая (11 %); классическая (74 %); симптоматическая (15 %). На современном этапе существует множество разных вариантов хирургического лечения. Основными эффективными и доказанными хирургическими методами лечения НТН считаются микроваскулярная декомпрессия корешка, радиохирургическая деструкция Гассерова узла, радиочастотная деструкция, глицериновая ризотомия, баллонная компрессия. Однако остаются открытыми вопросы диагностики причины заболевания и выбора адекватного хирургического метода лечения терапевтически резистентной НТН для конкретного пациента. Развитие хирургических методов начинается с древних времён и продолжается до наших дней. В представленном литературном обзоре отражены основные этапы развития нейрохирургических методов лечения. Описаны следующие оперативные методики: открытый метод – микроваскулярная декомпрессия; закрытые чрескожные деструктивные методы – радиочастотная деструкция, глицериновая ризотомия, баллонная компрессия, радиохирургия, криодеструкция, лазерная деструкция, инъекции ботулинотоксина.

The trigeminal nerve is a mixed fifth cranial nerve, consisting of motor and sensory components. The sensitive component receives somesthetic information from the skin and mucous membranes of the face into the central nervous system, and the motor component is responsible for the innervation of chewing muscles. One of the manifestations of the pathology of the trigeminal nerve is pain syndrome. Trigeminal neuralgia occupies the main place among neurogenic pain syndrome in the face, is characterized by а severe course and the absence of sufficiently effective methods of treatment. According to the World Health Organization (WHO), the prevalence of trigeminal neuralgia in different countries is 2–5 cases per 100 thousand people per year. Trigeminal neuralgia is classified into 3 etiologic categories. Idiopathic trigeminal neuralgia occurs without apparent cause. Classical trigeminal neuralgia is caused by vascular compression of the trigeminal nerve root. Secondary trigeminal neuralgia is the consequence of a major neurologic disease, e. g., a tumor of the cеrеbеllоpоntine angle or multiple sclerosis. Today, there are many different options for the surgical treatment of trigeminal neuralgia. microvascular decompression of the root, radiosurgical destruction of the Gasser’s node, radiofrequency destruction, glycerol rhizotomy, balloon microcompression are considered the main effective and proven surgical methods for treating trigeminal neuralgia. But the questions of diagnosing the cause of the disease and choosing an adequate surgical method for treating therapeutically resistant trigeminal neuralgia for a particular patient remain open. The development of surgical methods begins from ancient times to the present day. The main stages in the development of neurosurgical treatment methods are presented. The following surgical techniques are described: open method – microvascular decompression, and closed percutaneous destructive methods – radiofrequency destruction, glycerol rhizotomy, balloon compression, radiosurgery, cryodestruction, laser destruction, botulinum toxin injections.

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The authors declare that there are no conflicts of interest present.