Neuralgia del Trigémino

Aldair Buckcanan Vargas; Milena Mata Fuentes; Karen Fonseca Artavia

Aldair Buckcanan Vargas UNIMED Health System – AirEvac International, Puntarenas, Costa Rica. Médico General.
Milena Mata Fuentes Hospital Clínica Bíblica, San José, Costa Rica. Médico General.
Karen Fonseca Artavia Globalmed, Heredia, Costa Rica. Médico General.

Palabras clave: Puente de Varolio; V nervio craneal; dolor; compresión nerviosa; microcirugía. Fuente: DeCS

Resumen

La neuralgia del trigémino (NT) es una enfermedad cuya prevalencia es alta y corresponde a un porcentaje importante de neuralgias faciales; en donde las personas más afectadas son mayores de 50 años. Su manifestación clínica suele ser de cuadros de dolor facial severo y recurrentes, unilateral; en la distribución de una o más divisiones del nervio trigémino y no se explica con otro diagnóstico. El diagnóstico se basa en el cuadro clínico y usualmente no se encuentra déficit sensorial, sin embargo, si está presente se deben hacer neuroimágenes para descartar otras causas. En primera instancia está el manejo farmacológico. La carbamazepina se ha establecido como efectivo, llegando a producir un alivio del dolor dentro de las 24 horas. Cuando la farmacoterapia falla, se opta por la cirugía que se divide generalmente en dos: técnicas que destruyen la porción sensitiva del nervio; y la descompresión microvascular (DMV), que es la que tiene mejores resultados.

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