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Neurology:氨氯地平反应性三叉神经痛——病例报道

2017-08-15 杨中华 脑血管病及重症文献导读

氨氯地平减轻三叉神经痛的机制:电压门控钙通道能够减轻血管迂曲,以及N型通道(交感调节/镇痛作用)的作用。

氨氯地平减轻三叉神经痛的机制:电压门控钙通道能够减轻血管迂曲,以及N型通道(交感调节/镇痛作用)的作用。

55岁,女性,长期左侧下面部反复电击样疼痛。

因为发现高血压开始服用氨氯地平,服药后疼痛明显缓解。有时候漏服氨氯地平后疼痛复发。

脑MRI显示迂曲的血管压迫了左侧延髓前外侧和左侧三叉神经根。FIESTA序列显示左侧椎动脉(白色箭头)临近延髓前外侧(A图和B图)。MRA显示与右侧椎动脉相比,左侧椎动脉(白色箭头)行程比较局限(C图):



小脑前下动脉袢(红色箭头)临近左侧三叉神经根(白色箭头)(D-F图)。另外一支血管临近左侧三叉神经根的远侧(弯曲箭头)(E图):



作者认为氨氯地平减轻三叉神经痛的机制:电压门控钙通道能够减轻血管迂曲,以及N型通道(交感调节/镇痛作用)的作用。

文献出处:

R Uniyal , VK Paliwal , N Kumar ,et,al.Teaching NeuroImages: Amlodipine-responsive trigeminal neuralgia: An alibi for vascular compression theory.doi: 10.1212/WNL.0000000000004116.

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    2017-08-17 贵阳

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