TRIGEMINAL ROOT AND GANGLION INJECTIONS USING PHENOL IN GLYCERINE FOR RELIEF OF TRIGEMINAL NEURALGIA
TRIGEMINAL ROOT AND GANGLION INJECTIONS USING PHENOL IN GLYCERINE FOR RELIEF OF TRIGEMINAL NEURALGIA
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DOI：
10.1136/jnnp.26.4.345
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发表时间：
1963-01-01
影响因子：
11
通讯作者：
JEFFERSON, A
中科院分区：
文献类型：
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作者：
JEFFERSON, A
并不是所有负责治疗严重三叉神经痛的人都赞成三叉神经根或神经节注射。他们的反对意见是基于精确放置针尖的困难（随之而来的是成功结果的不确定性）和真实的或想象的危险。本文所述的三叉神经根和神经节注射的结果是使用溶解在甘油中的苯酚获得的。Maher（1955）介绍了这种药物用于椎管内注射，它的使用减轻了疼痛，但仅部分感觉丧失。控制三叉神经痛而不使面部受累部位完全麻木对患者来说是非常有利的。曾采用Hartel入路（Hartel，1912）进行颅内三叉神经注射的患者知道，针可以进入Meckel氏穴而不会刺穿三叉神经的第三分支、其神经节或其后根。在这些情况下，少量的酒精，例如，< 0-2毫升，可能无效。通过使用Maher'sagent与患者在直立的位置，设想的是，苯酚在甘油中的重溶液可以流过神经节，并在Meckel's cave内冲洗后根。通过这种方式，人们希望创建一个令人满意的神经损伤，而不必像当酒精是待注射的介质时那样精确地放置针尖。下文阐述了现实在多大程度上满足了这些希望。
By no means all those responsible for the treatment of severe trigeminal neuralgia view trigeminal root or ganglioninjections with favour. Their objections are based on the difficulty of precisely placing the needle point (with consequent uncertainty of a successful result) and on real or imagined dangers. The results of trigeminal root and ganglion injections described here have been obtained using phenol dissolved in glycerine. This agent was intro-duced by Maher (1955) for injection in the spinal canal, and its use relieved pain with only partial sensory loss. To control trigeminal neuralgia without producing total numbness of the affected areas of the face would be of undoubted advantage to the patient.Those who have used the Hartel approach (Hartel, 1912) for intracranial trigeminal injections know that the needle may enter Meckel's cave without impaling the third division of the tri-geminal nerve, or its ganglion, or its posterior root. Under these circumstances small quantities of alcohol, eg,< 0-2 ml., may prove ineffective. By using Maher'sagent with the patient in the upright position it was envisaged that the heavy solution of phenol in glycerine could be made to flow over the ganglion and to bathe the posterior root within Meckel's cave. In this way it was hoped to create a satisfactory neurological lesion without having to place the needle point as precisely as when alcohol is the medium to be injected. The extentto which reality has accorded with these hopes is set out below.