Diagnosis dan Tatalaksana Neuralgia Trigeminal Eksaserbasi Akut Terkini

Abstract

Neuralgia trigeminal (NT) ditandai oleh adanya nyeri seperti sengatan listrik singkat unilateral berulang, terbatas pada distribusi satu atau lebih cabang saraf trigeminal, onsetnya muncul dan berhenti tiba-tiba, dan dipicu oleh rangsangan yang normalnya tidak memunculkan rasa nyeri. Diagnosis NT adalah diagnosis klinis sesuai dengan kriteria diagnosis the International Classification of Headache Disorders. Pemeriksaan penunjang seperti Magnetic Resonance Imaging (MRI) dan tes elektrofisiologi diperlukan untuk menentukan etiologi. Etiologi NT penting untuk diketahui karena pendekatan terapi yang berbeda. Pada NT eksaserbasi akut terjadi peningkatan intensitas nyeri dan frekuensi serangan yang sangat tinggi. Kondisi ini menyebabkan anoreksia dan dehidrasi karena asupan makanan dan minuman akan memicu serangan nyeri. Perawatan di rumah sakit diperlukan untuk rehidrasi, pemeliharaan nutrisi, tatalaksana nyeri akut dan pengaturan dosis obat anti-konvulsan sebagai pencegahan nyeri  atau sampai dilakukan tindakan lain seperti pembedahan atau neuroablatif sesuai indikasi.

Acute Exacerbation of Trigeminal Neuralgia

Abstract

Trigeminal neuralgia (TN) is characterized by recurrent, brief unilateral electric shock-like pain, limited to the distribution of one or more branches of the trigeminal nerve, appearing and stopping suddenly, and triggered by stimuli that are normally painless. TN is a clinical diagnosis according to the diagnostic criteria of the international classification of headache disorders. Investigations such as magnetic resonance imaging (MRI) and electrophysiological tests are required to determine the etiology. It is important to know the etiology of NT because of the different therapeutic approaches. In acute exacerbations of TN, the pain intensity increases and the frequency of attacks is very high. This condition causes anorexia and dehydration because drinking or eating will trigger pain attacks. Hospitalization is needed for rehydration, nutritional maintenance, acute pain management and dose adjustment of anti-convulsant drugs as pain prevention or until other measures such as surgery or neuroablatives are carried out as indicated.