特发性与继发性三叉神经痛诊疗专家共识（2025版）

参考文献（下滑查看）：

[1]Bendtsen L , Zakrzewska JM , Heinskou TB ,et al. Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia[J]. Lancet Neurol, 2020,19(9):784-796. DOI: 10.1016/S1474-4422(20)30233-7 .

[2]Cruccu G , Di Stefano G , Truini A . Trigeminal neuralgia[J]. N Engl J Med, 2020,383(8):754-762. DOI: 10.1056/NEJMra1914484 .

[3]Chong MS , Bahra A , Zakrzewska JM . Guidelines for the management of trigeminal neuralgia[J]. Cleve Clin J Med, 2023,90(6):355-362. DOI: 10.3949/ccjm.90a.22052 .

[4]Hardaway FA , Gustafsson HC , Holste K ,et al. A novel scoring system as a preoperative predictor for pain-free survival after microsurgery for trigeminal neuralgia[J]. J Neurosurg, 2020,132(1):217-224. DOI: 10.3171/2018.9.JNS181208 .

[5]Thirumalai Vasu S , Retnathankom A . Trigeminal neuralgia in patients with cerebellopontine angle tumors : should we always blame the tumor? A case report and review of literature [J]. Scand J Pain, 2023,23(1):213-216. DOI: 10.1515/sjpain-2021-0215 .

[6]Houshi S , Tavallaei MJ , Barzegar M ,et al. Prevalence of trigeminal neuralgia in multiple sclerosis: a systematic review and meta-analysis[J]. Mult Scler Relat Disord, 2022,57:103472. DOI: 10.1016/j.msard.2021.103472 .

[7]Guyatt GH , Oxman AD , Vist GE ,et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations[J]. BMJ, 2008,336(7650):924-926. 10.1136/bmj.39489.470347.AD .

[8]Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition[J]. Cephalalgia, 2018,38(1):1-211. DOI: 10.1177/0333102417738202 .

[9]Wang H , Wang X , Li S ,et al. Surgical removal of foramen ovale osteophyte completely relieved atypical trigeminal neuralgia: a case report and literature review[J]. NMC Case Rep J, 2024,11:131-134. DOI: 10.2176/jns-nmc.2023-0194 .

[10]Li S , Liao C , Qian M ,et al. Narrow ovale foramina may be involved in the development of primary trigeminal neuralgia[J]. Front Neurol, 2022,13:1013216. DOI: 10.3389/fneur.2022.1013216 .

[11]Yang W , Sattari SA , Feghali J ,et al. Management outcomes of peripontine arteriovenous malformation patients presenting with trigeminal neuralgia[J]. J Neurosurg, 2024,140(2):515-521. DOI: 10.3171/2023.5.JNS23771 .

[12]Ahmed R , Lopez C , Philip K ,et al. Dural arteriovenous fistula and arteriovenous malformation presenting as tr igeminal neuralgia [J]. BMJ Case Rep, 2021,14(1):e240483. DOI: 10.1136/bcr-2020-240483 .

[13]De Toledo IP , Conti Réus J , Fernandes M ,et al. Prevalence of trigeminal neuralgia: a systematic review[J]. J Am Dent Assoc, 2016,147(7):570-576.e2. DOI: 10.1016/j.adaj.2016.02.014 .

[14]Svedung Wettervik T , Snel D , Kristiansson P ,et al. Incidence of trigeminal neuralgia: a population-based study in Central Sweden[J]. Eur J Pain, 2023,27(5):580-587. DOI: 10.1002/ejp.2081 .

[15]Laakso SM , Oh J , Raufdeen F ,et al. Trigeminal neuralgia within the disease course of MS: diagnostic and therapeutic implications from a multicenter cohort[J]. Mult Scler, 2025,31(5):607-611. DOI: 10.1177/13524585241309257 .

[16]王颖,刘瑞洁,杨治权,等. 桥小脑角肿瘤继发性三叉神经痛的临床病理特征[J]. 中南大学学报(医学版), 2024,49(4):588-594. DOI: 10.11817/j.issn.1672-7347.2024.230369 .

[17]Laakso SM , Hekali O , Kurdo G ,et al. Trigeminal neuralgia in multiple sclerosis: prevalence and association with demyelination[J]. Acta Neurol Scand, 2020,142(2):139-144. DOI: 10.1111/ane.13243 .

[18]Li S , Cheng G , Wu Y ,et al. Long-term pain outcomes in trigeminal neuralgia patients with concomitant continuous pain: a comparison of first-time microvascular decompression and percutaneous balloon compression[J]. Neurosurg Rev, 2023,46(1):183. DOI: 10.1007/s10143-023-02089-y .

[19]Di Stefano G , De Stefano G , Leone C ,et al. Concomitant continuous pain in patients with trigeminal neuralgia is associated with trigeminal nerve root atrophy[J]. Cephalalgia, 2020,40(13):1502-1510. DOI: 10.1177/0333102420949206 .

[20]Zhang YQ , Yu F , Zhao ZY ,et al. Surgical treatment of secondary trigeminal neuralgia induced by cerebellopontine angle tumors: a single-center experience[J]. World Neurosurg, 2020,141:e508-e513. DOI: 10.1016/j.wneu.2020.05.226 .

[21]Hallak H , Rindler R , Dang D ,et al. Trigeminal neuralgia pain outcomes following microsurgical resection versus stereotactic radiosurgery for petroclival meningiomas: a systematic review and meta-ana lysis [J]. J Neurosurg, 2024,140(2):420-429. DOI: 10.3171/2023.5.JNS222557 .

[22]Hughes MA , Jani RH , Fakhran S ,et al. Significance of degree of neurovascular compression in surgery for trigeminal neuralgia[J]. J Neurosurg, 2020,133(2):411-416. DOI: 10.3171/2019.3.JNS183174 .

[23]Huang Y , Huang Y , Xiao C ,et al. Preoperative evaluation of neurovascular relationship in primary trigeminal neuralgia(PTN) by magnetic resonance virtual endoscopy(MRVE) combined with 3D-FIESTA-c and 3D-TOF-MRA[J]. J Pain Res, 2024,17:2561-2570. DOI: 10.2147/JPR.S465956 .

[24]Hu M , Zhou W , Shen W ,et al. A combination of 3D TOF MRA and FIESTA predicts surgery-needed primary trigeminal neuralgia and specific offending vessels[J]. J Integr Neurosci, 2022,21(6):169. DOI: 10.31083/j.jin2106169 .

[25]Ma Z , Su X , Wang Z ,et al. A novel potential measurement indicator with objective and quantitative effect for trigeminal neuralgia: fractional anisotropy in MR-DTI[J]. Front Neurol, 2024,15:1453431. DOI: 10.3389/fneur.2024.1453431 .

[26]Cipollina GP , Costanzo R , Campisi BM ,et al. Pre-treatment DTI markers: predicting clinical outcomes in microvascular decompression for classic trigeminal neuralgia-a systematic review[J]. Neurosurg Rev, 2024,47(1):833. DOI: 10.1007/s10143-024-03062-z .

[27]Mousavi SH , Lindsey JW , Gupta RK ,et al. Trigeminal neuralgia in multiple sclerosis: association with demyelination and progression[J]. Mult Scler Relat Disord, 2023,74:104727. DOI: 10.1016/j.msard.2023.104727 .

[28]Kolakowski L , Pohl H , Stieglitz L ,et al. Interdisciplinary strategies for diagnosis and treatment of trigeminal neuralgia[J]. Swiss Med Wkly, 2024,154:3460. DOI: 10.57187/s.3460 .

[29]Cruccu G , Biasiotta A , Galeotti F ,et al. Diagnostic accuracy of trigeminal reflex testing in trigeminal neuralgia[J]. Neurology, 2006,66(1):139-141. DOI: 10.1212/01.wnl.0000191388.64530.8f .

[30]卢昊宁,张晓琴,车宏伟,等. MRI与CT诊断桥小脑角区占位性病变的临床价值以及影像学特征[J]. 中国实用医药, 2021,16(26):4-7. DOI: 10.14163/j.cnki.11-5547/r.2021.26.002 .

[31]Di Stefano G , De Stefano G , Leone C ,et al. Real-world effectiveness and tolerability of carbamazepine and oxcarbazepine in 354 patients with trigeminal neuralgia[J]. Eur J Pain, 2021,25(5):1064-1071. DOI: 10.1002/ejp.1727 .

[32]Ta P , Dinh HQ , Nguyen K ,et al. Efficacy of gabapentin in the treatment of trigeminal neuralgia: a systematic review of randomized controlled trials[J]. J Investig Clin Dent, 2019,10(4):e12448. DOI: 10.1111/jicd.12448 .

[33]Sangamesh NC , Bajoria AA , Mishra S ,et al. Comparative assessment of the effectiveness of carbamazepine and baclofen in the management of trigeminal neuralgia[J]. J Pharm Bioallied Sci, 2024,16(Suppl 3):S2197-S2198. DOI: 10.4103/jpbs.jpbs_139_24 .

[34]Hu X , Xia Y , Li J ,et al. Efficacy and safety of botulinum toxin type A in the treatment of trigeminal neuralgia: an update on systematic review with meta-analyses[J]. Clin J Pain, 2024,40(6):383-392. DOI: 10.1097/AJP.0000000000001207 .

[35]Attal N , Cruccu G , Baron R ,et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision[J]. Eur J Neurol, 2010,17(9):1113-e88. DOI: 10.1111/j.1468-1331.2010.02999.x .

[36]Sterman-Neto H , Fukuda CY , Duarte KP ,et al. Balloon compression vs radiofrequency for primary trigeminal neuralgia: a randomized, controlled trial[J]. Pain, 2021,162(3):919-929. DOI: 10.1097/j.pain.0000000000002070 .

[37]Zhang X , Peng L , Liu D . Radiofrequency therapies for trigeminal neuralgia: a systematic review and updated meta-analysis[J]. Pain Physician, 2022,25(9):E1327-E1337.

[38]Liu Q , Wang J , Wang C ,et al. Robot-assisted percutaneous balloon compression for trigeminal neuralgia: technique description and short-term clinical results[J]. Front Surg, 2022,9:869223. DOI: 10.3389/fsurg.2022.869223 .

[39]Tan K , Li J , Peng Y ,et al. Robot-assisted percutaneous balloon compression in elderly patients with trigeminal neuralgia[J]. J Pain Res, 2023,16:1161- 116 8 . DOI: 10.2147/JPR.S396680 .

[40]Texakalidis P , Xenos D , Tora MS ,et al. Comparative safety and efficacy of percutaneous approaches for the treatment of trigeminal neuralgia: a systematic review and meta-analysis[J]. Clin Neurol Neurosurg, 2019,182:112-122. DOI: 10.1016/j.clineuro.2019.05.011 .

[41]张云茜,王然,赵定亮,等. 改良Hartel入路在半月节射频热凝术治疗原发性三叉神经痛的疗效及安全性分析[J]. 中华医学杂志, 2023,103(15):1134-1139. DOI: 10.3760/cma.j.cn112137-20221220-02681 .

[42]赵薇. 清醒状态下CT引导经皮三叉神经节球囊压迫治疗三叉神经痛的疗效和安全性[J]. 中华医学杂志, 2023,103(7):493-493. DOI: 10.3760/cma.j.issn.0376-2491.2023.07.102 .

[43]Herta J , Loidl TB , Schmied T ,et al. Retrospective comparison of percutaneous balloon compression and radiofrequency-thermocoagulation in the management of trigeminal neuralgia[J]. Acta Neurochir (Wien), 2023,165(7):1943-1954. DOI: 10.1007/s00701-023-05656-w .

[44]Wu Z , Zhao Y , Liu J ,et al. Comparison of the safety and efficacy of radiofrequency thermocoagulation with percutaneous balloon compression for treating trigeminal neuralgia : a systematic review and meta-analysis [J]. Front Neurol, 2023,14:1178335. DOI: 10.3389/fneur.2023.1178335 .

[45]Liu G , Du Y , Wang X ,et al. Efficacy and safety of repeated percutaneous radiofrequency thermocoagulation for recurrent trigeminal neuralgia[J]. Front Neurol, 2018,9:1189. DOI: 10.3389/fneur.2018.01189 .

[46]Kourilsky A , Palpacuer C , Rogers A ,et al. Multivariate models to predict pain recurrence and sensitive complications after percutaneous balloon compression in trigeminal neuralgia[J]. J Neurosurg, 2022,137(5):1396-1405. DOI: 10.3171/2022.2.JNS212644 .

[47]Chen K , Wu J , Mei H ,et al. A nomogram based on radiomics and clinical information to predict prognosis in percutaneous balloon compression for the treatment of trigeminal neuralgia[J]. Neurosurg Rev, 2024,47(1):109. DOI: 10.1007/s10143-024-02339-7 .

[48]Zhao C , Ren H , Shrestha N ,et al. The efficacy of combining pulsed radiofrequency with low-temperature continuous radiofrequency for the treatment of primary trigeminal neuralgia: a randomized controlled trial[J]. J Neurosurg, 2025:1-11. DOI: 10.3171/2024.10.JNS241274 .

[49]Boling W , Song M , Shih W ,et al. Gamma knife radiosurgery for trigeminal neuralgia: a comparison of dose protocols[J]. Brain Sci, 2019,9(6):134. DOI: 10.3390/brainsci9060134 .

[50]Barzaghi LR , Albano L , Scudieri C ,et al. Factors affecting long-lasting pain relief after Gamma Knife radiosurgery for trigeminal neuralgia: a single institutional analysis and literature review[J]. Neurosurg Rev, 2021,44(5):2797-2808. DOI: 10.1007/s10143-021-01474-9 .

[51]Patra DP , Savardekar AR , Dossani RH ,et al. Repeat Gamma Knife radiosurgery versus microvascular decompression following failure of GKRS in trigeminal neuralgia: a systematic review and meta-analysis[J]. J Neurosurg, 2019,131(4):1197-1206. DOI: 10.3171/2018.5.JNS18583 .

[52]Helis CA , Hughes RT , Munley MT ,et al. Results of a third Gamma Knife radiosurgery for trigeminal neuralgia[J]. J Neurosurg, 2021,134(3):1237-1243. DOI: 10.3171/2020.2.JNS192876 .

[53]Sindou M , Howeidy T , Acevedo G . Anatomical observations during microvascular decompression for idiopathic trigeminal neuralgia (with correlations between topography of pain and site of the neurovascular conflict). Prospective study in a series of 579 patients[J]. Acta Neurochir (Wien), 2002,144(1):1-12; discussion 12-13. DOI: 10.1007/s701-002-8269-4 .

[54]Hitchon PW , Bathla G , Moritani T ,et al. Predictability of vascular conflict by MRI in trigeminal neuralgia[J]. Clin Neurol Neurosurg, 2019,182:171-176. DOI: 10.1016/j.clineuro.2019.05.005 .

[55]Zhang K , Liu D , Yang Z ,et al. Efficacy of internal neurolysis combined with microvascular decompression surgery in special types of trigeminal neuralgia[J]. Asian J Surg, 2024,47(8):3809-3810. DOI: 10.1016/j.asjsur.2024.04.139 .

[56]李明,关颖,于广洲,等. 颅内段三叉神经梳理术治疗三叉神经痛[J]. 中华耳鼻咽喉科杂志, 1995,30(6):377-377.

[57]Lavergne P , Piper K , Vinjamuri S ,et al. Internal neurolysis for trigeminal neuralgia: technical nuances and a single-institution experience[J]. World Neurosurg, 2024,184:e9-e16. DOI: 10.1016/j.wneu.2023.08.126 .

[58]Sabourin V , Lavergne P , Mazza J ,et al. Internal neurolysis for the treatment of trigeminal neuralgia: a systematic review[J]. World Neurosurg, 2022,158:e829-e842. DOI: 10.1016/j.wneu.2021.11.068 .

[59]Xu R , Materi J , Raj D ,et al. Internal neurolysis versus intraoperative glycerin rhizotomy for trigeminal neuralgia[J]. J Neurosurg, 2023,138(1):270-275. DOI: 10.3171/2022.3.JNS212956 .

[60]Amagasaki K , Tatebayashi K , Naemura K . Internal neurolysis for trigeminal neuralgia: a preliminary single-institution experience in Japan[J]. Neurol Med Chir (Tokyo), 2024,64(7):261-265. DOI: 10.2176/jns-nmc.2023-0285 .

[61]Yang DB , Wang ZM . The efficacy and safety of nerve combing for trigeminal neuralgia without neurovascular compression[J]. Acta Neurol Belg, 2019,119(3):439-444. DOI: 10.1007/s13760-019-01099-2 .

[62]Nugroho SW , Anindya Y , Hafif M ,et al. Open surgery vs. stereotactic radiosurgery for tumour-related trigeminal neuralgia: a systematic review[J]. Clin Neurol Neurosurg, 2023,228:107683. DOI: 10.1016/j.clineuro.2023.107683 .

[63]任智英. 亚低温疗法在神经科的应用[J]. 国外医学(神经病学神经外科学分册), 1999(5):231-233.

[64]Kai M , Yongjie L . Clinical features and surgical management of cerebellopontine angle cholesteatoma that presented as trigeminal neuralgia[J]. World Neurosurg, 2018,115:e7-e12. DOI: 10.1016/j.wneu.2018.02.047 .

[65]Liu P , Liao C , Zhong W ,et al. Symptomatic trigeminal neuralgia caused by cerebellopo ntine angle tumors [J]. J Craniofac Surg, 2017,28(3):e256-e258. DOI: 10.1097/SCS.0000000000003481 .

[66]Vernon V , Naik H , Guha A . Surgical management of cerebellopontine angle epidermoid cysts: an institutional experience of 10 years[J]. Br J Neurosurg, 2022,36(2):203-212. DOI: 10.1080/02688697.2020.1867058 .

[67]世界华人神经外科医师协会放射神经外科专业委员会. 中国三叉神经痛伽玛刀放射外科治疗专家共识(2020版)[J]. 中华神经外科杂志, 2020,36(10):984-989. DOI: 10.3760/cma.j.cn112050-20200403-00203 .

[68]Franzini A , Picozzi P , Farinaro G ,et al. Gamma Knife radiosurgery targeting the trigeminal nerve for tumor-related trigeminal neuralgia: a case series[J]. World Neurosurg, 2023,175:e413-e420. DOI: 10.1016/j.wneu.2023.03.113 .

[69]Peciu-Florianu I , Régis J , Levivier M ,et al. Trigeminal neuralgia secondary to meningiomas and Vestibular Schwannoma is improved after stereotactic radiosurgery: a systematic review and meta-analysis[J]. Stereotact Funct Neurosurg, 2021,99(1):6-16. DOI: 10.1159/000509842 .

[70]Hall JC , Ung TH , McCleary TL ,et al. Stereotactic radiosurgery for trigeminal neuralgia secondary to tumor: a single-institution retrospective series[J]. Neurosurg Focus, 2022,53(5):E3. DOI: 10.3171/2022.8.FOCUS22381 .

[71]Zheng C , Yitong J , Zipu J ,et al. The long-term outcome of 3-Dimensional CT-guided percutaneous radiofrequency thermocoagulation for tumor-related trigeminal neuralgia[J]. Pain Physician, 2019,22(5):E467-E475.

[72]Jiang C , Jia Y , Chong Y ,et al. Percutaneous balloon compression for secondary trigeminal neuralgia caused by cerebellopontine angle tumors[J]. Acta Neurochir (Wien), 2022,164(11):2975-2979. DOI: 10.1007/s00701-022-05247-1 .

[73]Castelli N , Innocenti N , Ferroli P ,et al. Microvascular decompression for trigeminal neuralgia: a single-center experience with 516 cases, including 32 patients with multiple sclerosis[J]. Acta Neurochir (Wien), 2023,165(12):3887-3893. DOI: 10.1007/s00701-023-05872-4 .

[74]Mazzapicchi E , Broggi M , Restelli F ,et al. Trigeminal neuralgia in multiple sclerosis: proposal of surgical flowchart and long-term outcome evaluation in a mono-istitutional cohort[J]. Neurol Sci, 2025,46(4):1789-1798. DOI: 10.1007/s10072-024-07909-7 .

[75]Paulo DL , Lopez AM , Jermakowicz WJ ,et al. Microvascular decompression for trigeminal neuralgia in patients with multiple sclerosis: predictors of treatment success[J]. World Neurosurg, 2020,136:e165-e170. DOI: 10.1016/j.wneu.2019.12.081 .

[76]Zakrzewska JM , Wu J , Brathwaite TS . A systematic review of the management of trigeminal neuralgia in patients with multiple sclerosis[J]. World Neurosurg, 2018,111:291-306. DOI: 10.1016/j.wneu.2017.12.147 .

[77]Mousavi SH , Gehling P , Burchiel KJ . The long-term outcome of radiofrequency ablation in multiple sclerosis-related symptomatic trigeminal neuralgia[J]. Neurosurgery, 2022,90(3):293-299. DOI: 10.1227/NEU.0000000000001817 .

[78]Przybylowski CJ , Cole TS , Baranoski JF ,et al. Radiosurgery for multiple sclerosis-related trigeminal neuralgia: retrospective review of long-term outcomes[J]. J Neurosurg, 2019,131(5):1583-1590. DOI: 10.3171/2018.5.JNS173194 .

[79]Xu Z , Mathieu D , Heroux F ,et al. Stereotactic radiosurgery for trigeminal neuralgia in patients with multiple sclerosis: a multicenter study[J]. Neurosurgery, 2019,84(2):499-505. DOI: 10.1093/neuros/nyy142 .

[80]Ali S , Shafique MA , Mustafa MS ,et al. Effectiveness of gamma knife radiosurgery in the management of trigeminal neuralgia associated with multiple sclerosis: a systematic review and meta-analysis[J]. Neurosurg Rev, 2023,47(1):12. DOI: 10.1007/s10143-023-02246-3 .

[81]Franzini A , Picozzi P , Baram A ,et al. Repeat Gamma Knife radiosurgery for recurrent trigeminal neuralgia in patients with multiple sclerosis: a single-center retrospective study[J]. Acta Neurochir (Wien), 2024,166(1):15. DOI: 10.1007/s00701-024-05913-6 .

[82]Spina A , Nocera G , Boari N ,et al. Efficacy of Gamma Knife radiosurgery in the management of multiple sclerosis-related trigeminal neuralgia: a systematic review and meta-analysis[J]. Neurosurg Rev, 2021,44(6):3069-3077. DOI: 10.1007/s10143-021-01507-3 .

版权归中华医学会所有。

关注“钟书医生”公众号：专治脑血管病，科普医学知识，追求文明生活!