Causes of inflammation of the facial trichaminal nerve. Treatment of neuralgia of the trigeminal nerve in a different way Symptoms of inflammation of the trigeminal nerve

Short-hour intensive bіl vinikaє schoraz, if they appear. Medical treatment in such situations may be considered a cure. Competent therapy of ill-health allows not only to reduce the symptoms, but also to repeat similar conditions and make it worse.

Intense bіl, sho raptov blames on the face, head, at the hides, crevices zmushuє people shukati shukati, sob to get rid of the symptoms of inflammation of the facial nerve. In such situations, self-exaltation can lead to negative consequences; it is necessary to go to the medical mortgage. The liquor of the tripartite nerve is to blame.

Today, it is effective to treat the inflamed trigeminal nerve using the following methods:

Conservative methods of therapy are the most common. Only in vinyatkovyh situations, if it is impossible to get sick with symptoms and physiotherapy procedures, go to surgery. In this case, the doctor uses pressure on the nerve fiber or the nerve that causes pain.

Modern times allow you to make a sprat of the day. Nasampered likar prescribes faces, yakі reduce sickness symptoms. The onset stage of exuberance lies in the use of factors that provoked neuralgia. The final phase of therapy is due to include prophylactic drugs and against repeated attacks of trigeminal nerve inflammation on the face.

Faces in the pain and inflamed

The most popular medicinal preparations for - anti-inflammatory and pain-relieving diseases. Ring out such names in short courses. The stench allows you to reduce the inflammation and soreness.

Nimesulide (Nimesil, Nemulex, Nimika, Nimulid) is considered to be the most effective drug. Preparations quickly reduce the intensity of the ignition process. The duration of therapy is from three to seven days. Nimesulide vikoristovuetsya internally or in ointments.

Diclofenac (Ortofen, Voltaren, Diklak, Dicloberl) in the form of ointments, gels is used as a pain reliever. In the case of injections, tablets and capsules, it changes the inflammation of the tripartite nerve and that in appearance.

Preparations that include ibuprofen (Ibuprom, Nurofen) before the warehouse, reduce symptoms and pain and inflammation. The medicinal value can be shown to be effective and low toxic. Ibuprofen is available in the form of tablets, capsules and ointments.

Rіdshe likar usunennya pain may be recognized by katadolon, xefocam, dexalgin, ketorolac. Injection of analgin with diphenhydramine helps to relieve symptoms of pain, along with inflammation.

Some people do not dare to attack the attacks of neuralgia, which are repeated, in the guise of the most significant painful non-steroidal diseases. Larger doses of drugs less likely to increase toxicity and severity of side effects. In order to overcome the problem, the doctor can recognize faces that relax the mind - muscle relaxants.

Be-yaky bіl provokuє spasm. In the sight of this, the bloody oozing of the sickly woman on the faces, slits, heads. Poor bloodshed will aggravate the situation, even if the spasm is less likely to get worse. In order to develop it as a whole, at the same time, from non-steroidal pain-relieving methods, the doctor recommends taking muscle relaxants (tolperisone or tizanidine).

The congestion of muscle relaxants at the same time with non-steroidal analgesic drugs will speed up the contraction, effectively helping to get into pain. In addition, for the treatment of sleeping with tolperisone or tizanidine, it is possible to reduce the dose of painkillers with antiseptic methods.

Anti-suicide care

Preparations with an antisudominal effect are associated with symptoms of inflammation of the trigeminal nerve. Carbamazepine, Gabapentin, Clonazepam by way of galvanizing the transmission of pathological impulses in nerve endings help to reduce the number of attacks in pain, which is blamed. Anti-diabetic drugs prescribe only a drug, individually adjusting the dose, frequency and duration of drug administration.

Carbamazepine, Clonazepam and Gabapentin are being tested step by step. The course of therapy can last for a few months until the next day. For the help of anti-suicide remedies, one can successfully treat the inflammation of the tripartite nerve and eliminate the symptoms of a disease.

Preparations for the treatment of causes of neuritis

The inflamed tripartite nerve can be easily twisted, otherwise it will take care of the sons of the clerks, served as a post for the development of ailments. Infectious diseases, injuries, nerve disorders, mechanical compression of nerve fibers provoke the appearance of pain sensations in neuritis of the trigeminal nerve.

You can fight with herpes and cold ailments for help with antiviral drugs. Preparations of interferon and acyclovir treat the development of the herpes virus, which affects the nerve fibers and leads to the pathology of the facial nerve.

Use ailments in appearance, which appear in stressful situations, help sedative drugs and vitamins of group B. Optimally, as a calming drug (afobazole, glycine, phenibut, mebicar) prescribe the drug.

Therapeutic care, which helps to eliminate the vitamins of group B (milgam, combipen, neurobion, neuromultivit), help to restore the normal functioning of nerve fibers.

Sometimes the disease of the trigeminal nerve is provoked by sinusitis, sinusitis, allergies and dental pathologies. In such situations, it is important to rejoice at the same time and ailments and seek help from a doctor. There may be signs of antibacterial drugs, antiallergic drugs.

For the treatment of the pathology of the facial nerve, the faces are also vicorated to reduce the activity of the blood vessels. As an illness caused by atherosclerosis, it is generally prescribed drugs to lower cholesterol levels: simvastatin, atorvastatin, rosuvastatin, fenofibrate. Other recommended medications that optimize cerebral blood circulation: vinpocetine, ginkgo biloba, piracetam, cinnarizine, betahistine.

Additional therapies

In order to quickly manage the symptoms of illness, it is necessary to take a comprehensive approach to recovery. Pharmaceutical preparations may be congested in the form of injectable tablets. Various physiotherapeutic procedures are effectively carried out with different medications.

Non-steroidal antiseizure drugs (analgin, diclofenac), antispasmodic drugs (drotaverine, magnesium sulfate) are successfully used for electrophoresis in case of damage to the trigeminal nerve. Compresses with dimexide, painkillers, glucocorticoids (hydrocortisone, prednisolone, dexamethasone) help to reduce inflammation in the home.

As dodatkovі zasobi can vicoristowate medicinal plants. Luxurious herbal teas, baths with herbs and essential oils help to calm the nervous system, restore health.

It is practically impossible to vilify the inflammation of the facial nerve. At the same hour today, the doctor may have a solid arsenal of benefits and may indicate an effective medical treatment of inflammation of the trigeminal nerve. The complex therapy of the building is long overdue for the appearance of sickly attacks of neuralgia of the facial nerve.

Tripartite neuralgia- ce chronic inflammation of the tripartite nerve (the most sensitive nerve of the face), which is characterized by an attack-like pain syndrome.

So they call the disease facial or trigeminal(from Latin trigeminus or triparties) neuralgia.

Trochs of statistics!

Tripartite neuralgia occurs in 40-50 episodes per 100,000 population, and about 5 cases per 100,000 population.

For statistics, women often fall ill for 50 years. Younger people are more likely to get sick, and there are a number of cases of illness in children of the preschool age.

Not a lot of facts!

• The first descriptions of neuralgia of the trigeminal nerve are recorded in old dzherelakh. So the Chinese healer Hua Tuo was the first to stop acupuncture in case of any ailment, but the procedure did not rejoice, but more than temporally reduced the pain syndrome. Hua Tuo was the ruler of the Chinese Empire, who suffered from such an ailment for those that the doctor did not lean on him, for an hour I would attack facial pain. Such a bіl buv is unbearable for a commander.
• Trigeminal neuralgia can lead to idiopathic illnesses, which are illnesses with an unknown cause. Arguing about what to bring to the point of illness among scientists is already rich, but no consensus has been found.
• Manifesting neuralgia of the trigeminal nerve can induce toothache, which is why dentists are often the first to bite. In case of any patient, they indicate the presence of an absolutely healthy tooth, such a tooth can be seen for a few years.
• Stressful situations and operative intervention on the face in the empty mouth are used to relieve the temporal (up to a few months) remission of the pain syndrome in trigeminal neuralgia.
• Primary non-narcotic analgesics are not effective in treating neuralgia, stench can change the pain less and less, with skin application less and less help.
• Parts of the attack of unbearable pain in case of neuralgia of the trigeminal nerve can destroy the mental state of the sick person, leading to depression, fears, aggressive states, psychosis.
• An attack of pain with neuralgia of the trigeminal nerve can call for a light dot, for example, applied to the cream on the face.

How to practice nerves?

Nervous system- One of the most important and folding systems of the body, as it regulates, controls and influences all the processes that occur in the human body. We can’t do anything: we can’t collapse, we can’t think, we can’t show emotions, we can’t breathe, we can’t repair foreign agents and we can’t grow up without the participation of the nervous system.

The nervous system of a human being, especially the head brain, has not yet been trained to the last day and is the core for new awards and Nobel Prizes. It is practically impossible for Adzhe to transfer the reaction of a person to different subdivisions at that second moment, to show the ability of a person, to understand the compensatory ability of the brain after injuries, infections and other pathological states of the nervous system.

The first most important function of a human being, which is controlled by the nervous system - intellect, exalts and magnifies us above other things of the planet Earth. A majestic number of scientists work over the creations of a piece of intelligence, but at the moment it’s impossible, the human nervous system is thought out by nature to the point of detail and is not repeated.

Budova nervous system

Central nervous system

The central nervous system in humans is represented by cephalic and spinal cord.

Main functions of the central nervous system:

• regulating the functioning of all organs and systems, coordinating their joint synchronous work,
• ensure an adequate response of the body to different factors and the world of the world,
• the development of mental functions, reason, thought, emotions, just to excite us, people, from other sources.

Basic structures of the brain:

1. bark brain,
2. great pivkul brain (kіntsevy mozok),
3. intermediate brain: thalamus, hypothalamus, epithalamus, hypophysis,
4. middle brain: dah of the middle brain, lower brain, water supply of the middle brain,
5. posterior brain: mist of the brain, brain, dovgasty brain.

Rice. Schematic representation of the main structures of the brain.

peripheral nervous system

The craniocerebral and spinal nerves extend to the peripheral nerves.

Main functions of the peripheral nervous system:

• selection of information from dovkill, as well as about the internal state of systems and human organs,
• transmission of impulses with information to the central nervous system,
• coordination of the work of internal organs,
• zdіysnennya ruhіv,
• regulation of the functions of the circulatory system and others.

Features of the peripheral nervous system:

• somatic nervous system- Changes and selection of information and calls in the middle.
• The autonomic nervous system:
  • nice nervous system activates at the moment of stress, anxiety, reaction to stress factors and internal environment;
  • parasympathetic nervous system aktivіzuetsya under the hour of calm, invigoration and sleep;
  • enteric nervous system Vіdpovіdaє for the work of all vіddіlіv shlunkovo-intestinal tract.

craniocerebral nerves- the nerves that enter the brain, the head rank regulate the work of the organs and m'yaziv head, shii, disguise.

For their functions, the craniocerebral nerves can be subdivided into:

• sensitive nerves- in response to the transmission of the nerve impulse to the cerebellum by organs of perception (hearing, smell, smell, relish, sensitivity of the skin and mucous membranes);
• Rukhovi nerves- Reply for work m'yaziv;
• jittery nerves- nerves that may be sensitive and ruhovі functions.

Humans have 12 pairs of cranial nerves. The cutaneous craniocerebral nerve has its own nucleus* in the central nervous system, which is most importantly located in the intermedium, middle and posterior cerebellum.

* Nuclei of the cranial nerves- This is the establishment of the nervous system, yakі otrimuyut and transmit nerve impulses of the peripheral nervous system, and the craniocerebral nerves themselves.

Nerves under a microscope

Neuron (nervous clitina or neurocyte)- є structural unity of the nervous system, tsі kіtini є vysokospetsіalіzovannymi, zdatnі vіdtvoryuvate and transmit nerve impulses, yakі for their characteristics are already similar to electrical ones.

Neurons by size vary in size depending on the function of that species, on average 10 to 30 µm (minimum 3, maximum 120 µm).

"Nervous cells don't get excited!" - It's true, what's the myth?

Skіlki razіv kozhen іz us chuv tsey vislіv vіd likarіv, vchitelіv, batkіv. Ale american testimony in 1999 rozі buv chastkovo rozvіchany tsey myth. Elizabeth Gould and Charles Gross were told that the central nervous system generates thousands of new neurons every day with a long life, the stench is allowed, for the rahunka of these new cells, a person is fully remembered, new skills and knowledge are revealed. Tobto tse sobі arkushі white paper, on like skin people write down something new for themselves. We are directly carrying out investigations, to what stink to bring the teachings of the world, no one knows, but it’s better to turn over our statements about the work of the nervous system for all the investigations. I, it is possible, new ideas will help to know effective methods of treatment of illness, which at the moment are considered irreversible, such as sclerosis, Parkinson's disease, Alzheimer's syndrome and others.

Budova neuroniv

What is a neuron made up of?

• Vіrostki dendriti- take impulses from other cells, sound like a hollow shape (like a tree, a skin hull extends further into the hulls). Neurons have a large number of dendrites, but in some clitins, each child can be alone (for example, neurons of cells that transmit impulses of photoreceptors in the eye).
• Thilo neuron (soma) with the nucleus and other organelles. The body of the neuron is covered with two balls of fat (lipid membrane), a protein ball and a pool of polysaccharides (carbohydrates). Zavdyaki such a budovі kіtinnoї membrane, the body of the neuron is not able to process nerve impulses, in a new one there is accumulation of the impulse.
  Soma also takes care of the food of the clitin and the observation of her products of life.
• Axon humpback- Location of the body of the neuron, which way the neuron's axon grows, the function and structure of the regulation of the transmission of the nerve impulse to the axon, so that the axon is awakened.
• Vіdrostok axon- a long-term seed, by which information is transmitted to other neurons. In the skin neuron, there is one axon, which is the last one, and the nerve impulse is better transmitted there. Endings of axons are subdivided into terminal veins, the stench itself joins with other nerve cells. The axon can be covered with a myelin sheath or without it.
• Myelin sheathє such an electrical insulator, the membrane itself, which is composed of lipids and proteins. It consists of glial clitins (Schwann clitins in the peripheral nervous system and oligodendrocytes in the central nervous system), which spirally envelop the axon. Between glial clitins and wiggles - ragged lacerations, as if not covered with myelin. Zavdyaki myelin electrical impulse is transmitted along the nerves quickly.

When damaged, caused by the collapse of the myelin sheath, severe diseases develop - sclerosis, diffuse sclerosis, encephalopathy, neuro-SNID and other conditions.

See neurons, fallow in victorious functions:

• rukhovі neurons - transmit impulses from the central nervous system to the peripheral nerves of the mucous membranes,
• sensitive neurons - transform impulses from the superfluous or internal medium and transmit them to the central nervous system,
• insert neurons - neurons that transmit impulses from one neuron to another, more importantly, intercalary neurons are represented by nerve cells of the central nervous system.

Nerve fibers- Axons of neurons.

Nervi- Bundles (bundles) of nerve fibers.

Building of neurons

Neurons unite among themselves, establishing synapses. Through them, one nerve cell (which transmits) transmits a nerve impulse to the other nerve cell (which receives).

The synapse can also connect the nerve clitin with the tissue clitins that innervate (mud, burrow, organ).

The cephalic and dorsal cerebellum is a large crowding of neurons among themselves, yakі may be folded to the edge of interrelationships.

Storage synapse:

• Axon of the transmission neuron(Yogo presynaptic termination), building stimulus to vibrate special chemicals that transmit impulses - mediators. Mediators of the nervous system (neurotransmitters, neurotransmitters) are vibrated in the synaptic pimples of the presynaptic ending.
• Synaptic gap an impulse is transmitted through it.
• Part of the clitin, what do you take- abo receptors on whether spriyyatlivy clitin. Receptors can spread in the dendrites, axons or neurons, on the membranes of sensitive cells, internal organs, organs of the sensibility, follicles, and so on.

Groups of neurotransmitters (neurotransmitters):

• Monoamines: histamine, serotonin;
• Amino acids: Gama-aminobutyric acid (GABA), glycine, glutamic and aspartic acid;
• Catecholamines: epinephrine, norepinephrine, dopamine;
• Other neurotransmitters: acetylcholine, taurine, ATP and more.

How is a nerve impulse transmitted?

nerve impulse- tse natural electricity, yak to pass by electric wires (nerves) at different straight lines and behind singing trajectories. Tsya electricity (impulse), which can be chemically inspired, is used for the help of mediators of the nervous system and ions (for example, sodium and potassium).

Stages of adoption and transmission of a nerve impulse:

1. Damaged neuron.
2. The inclusion of a sodium-potassium pump, so that sodium through special sodium channels passes through the middle of the excited cell, and potassium through potassium channels - from the cell.
3. Illumination of the difference of potentials between the membranes of the synapse (depolarization).
4. The formation of a nerve impulse is the potential of di.
5. Transmission of a nerve impulse through nerve fibers through a synapse:
   • secretion of neurotransmitters in synaptic bulbs of the transmission ending,
   • release of mediators (or speeches that destroy them - in the process of galvanization) at the synaptic gap,
   • stimulation of depolarization of the receiving cells (opening of the sodium and potassium channels) - in case of nerve fiber excitation, or hyperpolarization (closing of the sodium-potassium channels) in case of galvanic ** ,
   • transmission of the impulse far along the nerve fibers to the central nervous system or the organ that is innervated.

**All the processes of stimulating the nervous system are constantly being drawn by the processes of galvanization, qi processes are regulated in the axon and tili of the neuron for the help of singing neurotransmitters, yakі may have a galvanic effect.

The rate of transmission of a nerve impulse by nerve fibers covered with myelin is 2-120 m/s.

Crimean transmission of the nerve struma through the synapse, it is possible to expand the impulse without the middle by a contact path, without the participation of mediators, with a strong expansion of the nerve cells.

Tsikavo! You can watch the video: “Neymovirne has finished us. nervous system".

Reflex- Tse reaction of the body to any podraznik in the middle or calling the body. In ciomu obov'yazkovo take the fate of the central nervous system.

The reflex is the basis of the functioning of the nervous system, practically all nerve processes go through additional reflexes.

In the process of the reflex, the nerve impulse passes through the reflex arc:

• receptors of singing cells, organs and tissues,
• Sensitive nerve fibers work and transmit nerve impulses to the organs that are innervated,
• analysis of impulses in the central nervous system,
• Rough nerve fibers transmit impulses to the organs that are innervated - respond to a subcase.

Reflections are:

• smart,
• insane.

In the mental reflex, the nervous system, the cerebral cortex, takes part in the mental reflex, and the insane reflexes are formed without participation.

Cі reflections develop as an automatic reaction to calls and internal officials. Crazy reactions make a person’s building up to self-saving, sticking to the minds of a superfluous middle, multiplying, saving homeostasis - becoming the body’s internal become. The stench is genetically imbued and is transmitted from generation to generation.

Apply insane reflexes: pissing of breast milk by a new-born baby, statevy, maternal and other instincts, blinking in case of a threat of injury to the eye, coughing and spitting when external particles get into the dyschyna path.

Tripartite nerve

The tripartite nerve is the fifth pair of cranial nerves. I’ll take the name off through the presence of a newcomer three heads:

• ochna (upper) neck,
• upper slit (middle) hilt,
• lower slit (lower) nail.

Before the exit of the tripartite nerve from the skull, the nerve establishes a great nerve vuzol - tripartite ganglion ***.

Characteristics of the tripartite nerve

Parameters	Characteristic
	ophthalmic nerve	superior scapular nerve	Inferior jaw nerve
Looking nervous	sensitive	sensitive	disturbing nerve
What do they innervate?	The skin of the frontal, skronevy and thym'yanoy areas, the back of the nose, the capital (upper), often mucus of the nose and sinuses, very apple, often slugs often meninges.	Shkіra of the capital (lower), upper lip and part of the face, upper teeth	Sensitive fibers- Shkir of the area of ​​the lower fissure, empty mouth (mucous membrane of the cheek, sublingual region, part of the tongue) alveoli of the teeth, sinus ridges, tympanic strings of the ear and the dura mater. Dviguni- chewing m'yazi disguise, and itself: double m'yaz (located in pіd'yazychnіy dilyantsі), wing-like and skronevy m'yaz.
Main functions	Sensitivity of the skins, regulation of the secretion of tears, sensitivity of the meninges	Shkiri's sensitivity	sensitivity of the mucous membrane of the mouth and skin, sensitivity of the meninges, innervation of teeth, participation in the act of living, innervation of the sinuses, spriynyattya sound in a drum string - a sensitive organ of the ear.
Misce out of the skull	The outer wall of the ophthalmic fossa.	rounded opening - to be known in person.	Ovalne otvir - to be known by the eye.
Main nerve fibers	mucus nerve, frontal nerve, nasociliary nerve. Rice. #1	knots, vilic nerves: vilic and vilic, pit and pit nerves (one of the hilars is the upper and posterior upper alveoli). Rice. #1	meningeal tubercle, chewing nerve, deep skeletal nerves. wing-like nerves, buccal nerve, ear-skronevy, lingual, lower alveolar. Rice. #2
Nerve knots (ganglia)**, affixed by the tripartite nerve	Viykovy vuzol: parotid nerve (III pair of cranial nerves), nasociliary nerve.	Crilopidnebіnny vuzol: knots, sympathetic and parasympathetic nerves of the great and deep stony nerves (glandes of the intermediary nerve, which extends to the craniocerebral nerves).	Vushny vuzol: mali kamyanisty nerve (gulka of the tongue-pharyngeal nerve - IX pair of cranial nerves), inferior sciatic nerve. Lower gap vuzol: lingual nerve (gylka of the lower jaw nerve), needles that innervate the sleighs, drum string fibers
nuclei in the brain	Dviguni tricuspid nerve located at the bridge (posterior brain) - rukhovi nuclei of the trigeminal nerve. Sensitive fibers tricuspid nerve to pass through the lower brain, represented by sensitive nuclei in the brain: kernels of the upper sensitive way, located in the bridge of the brain, nuclei of the spinal cord to know in the dovetailed brain, nuclei of the mesencephalon znahoditsya in the middle brain bіla plumbing and often in the bridge of the posterior brain.

*** Nerve nodes or ganglia- The accumulation of nerve tissue, which avenges nerve fibers and nerve centers in oneself, connects two or more nerve fibers, receiving impulses, both in the end and in the central nervous system (visual and lower flows).

Rice. No. 1: The ophthalmic and superior sphenoid nerve of those hilars.

Rice. No. 2: Inferior slit nerve and thoracic nerve.

Causes of trigeminal neuralgia

Behind the mechanism of vindication of neuralgia of the trigeminal nerve, pathology can be either primary or true (isolation of the lesion of the trichaminal nerve) or secondary (manifesting neuralgia as a symptom of systemic disease of the nervous system).

The exact reason for the development of neuralgia of the triple nerve is not known, as already mentioned above, it can be attributed to idiopathic illnesses. Ale razrіznyayut officials, yakі most often lead to the development of this disease.

Officials, how to spriyat the development of neuralgia of the triacous nerve:

1. Triple nerve pressure at the cranial box or yogo gіlok after leaving the skull:
   • dilatation of vessels of the brain: aneurysms (pathological expansion of the vessels), atherosclerosis, hemorrhagic and ischemic stroke, development of the intracranial vice as a result of osteochondrosis of the cervical spine, congenital anomalies of the development of the vessels and so on - the most common cause of the development of the neuralgia of the trinary nerve
   • plump the brain and the facial region along the hilok of the trigeminal nerve,
   • injuries those post-traumatic scars,
   • injuries in the area of ​​the slit-skinned loam,
   • growth of happy fabrics(adhesions) due to an infectious ignition process, sclerosis due to damage to the myelin sheath of nerve fibers.
   • congenital anomalies development of the cystic structures of the skull
2. Viral nerve injury: herpetic infection, poliomyelitis, neuro-SNID.
3. Illness of the nervous system:
   • pink sclerosis,
   • infantile central paralysis (ICP),
   • meningitis, meningoencephalitis (viral, tuberculosis),
   • encephalopathy due to head injuries, infectious processes, hypoxia (not enough sourness in the brain), lack of life speech,
   • swelling of the brain and damage to the blood circulation in the area of ​​the nuclei and fibers of the trichamoidal nerve is thin.
4. Odontogenic causes(tied with teeth):
   • “Not far away” is the filling of the teeth and the other surgical insertion at the sphere of appearance and the empty mouth.
   • reaction to anesthesia of the canals of the teeth,
   • injury to the gap with the teeth,
   • dental flux.

Officials that increase the risk of development of trigeminal neuralgia:

• vіk ponad 50 rokіv,
• mental disorder,
• chronic vtom,
• stress,
• overcooling of an individual (for example, on protya),
• avitaminosis (not enough vitamins in group B),
• impaired speech exchange: gout, circulatory diabetes, thyroid disease and other endocrine pathologies,
• helminthiasis (worms),
• starvation, impaired wetting of the living tongues in the intestines, bulimia, anorexia,
• inflammation with swollen mucous membrane of the maxillary and other navolonic sinuses (chronic sinusitis),
• inflammation processes and abscesses (abscesses, phlegmons) in the mouth empty - gingivitis, pulpitis,
• suppuration of the skull bones, especially cleft (osteomyelitis),
• hospitals and chronic infections with severe intoxication: malaria, syphilis, tuberculosis, brucellosis, botulism, right-wingers and so on.
• autoimmune disease,
• severe allergic disease.

Mechanism of development (pathogenesis) of neuralgia of the trigeminal nerve

In order to drive the pathogenesis of the development of neuralgia of the trichamoidal nerve, they discuss a lot of the whole world in a wide variety of ways. Fallen due to reasons that have taken the blame for neuralgia of the triple nerve, two theory of yoga development mechanism:

I want the skin theory to have “dark patches”, let it be that the insult to the mechanisms of the development of the pain syndrome can take place, so that one by one follows one by one. For the same reason, the treatment of neuralgia of the trichaminal nerve can be complexly directed to the introduction of the myelin sheath of nerve fibers and to the galvanization of nerve processes in the brain.

Tripartite neuralgia symptoms

The main symptom of trigeminal neuralgia is pain in the area of ​​appearance, but it also manifests a aggravation of this disease, which does not cause such discomfort, as unbearable pain, but can additionally indicate itself to trigeminal neuralgia.

Symptom	How does it appear?	When does a symptom appear?
Bіl at the sphere of appearance	Pain syndrome manifests itself less in one half of the appearance. The attack is similar, otherwise it is called paroxysmal, attack is replaced by periods of calm. Bіl unbearable, prostrіuvalny character, yogo is often compared with electric shocks. The patient at qi momentarily freezes at that station, who has an attack, tries not to break, clasps his hands at the place of localization of pain. Approach the pain, ring out for a few seconds to a few breaths. Periods of calm can roll from many years to many months. In some cases, with a non-typical overrun or a neglected trivial overrun, illness, in particular, that head would have a practically permanent character. With the trivality of illness, the trivality of the attacks increases, and the period of remission is short.	Bіl zazvychay z'yavlyaєtsya after di ї drіvlivih factors. On the face of the zone, so called trigger (in the literature, the term algogenic dilyanki can be used), with an insignificant teasing of them, a pain attack can begin. With this rough action on the qi points, the attack will often lead to yogo cupping (pinning). Localization of trigger points is individual: ruin, nasal krill, arch eyebrows, the middle part of the pіdboridya, place z'ednanny schelep (splintered-skronevy loam), chocks, outward auditory passage, empty mouth: teeth, inner surface of the cheek, clear, tongue. It can be blamed both for strong impacts of those other coarse factors of teasing areas of these points, and for insignificant teasing of trigger zones: cry, chuckle, chuckle, rozmov, zhuvannya, reception їzhi, changing the temperature, repeating, stretching, pozihannya, chhannya, teeth cleaning, vmivannya, applying cream, make-up, golinnya and so іnshe. Rice. Possible trigger zones in case of trigeminal nerve neuralgia.
	Localization of pain**** Skronevo-tim'yan area of ​​the head, povіki, and the area around the front of the apple, nіs, the head as a whole.	In case of damage to the ophthalmic nerve of the trichamoidal nerve.
	Upper teeth, upper slits, upper lip and cheek.	In case of damage to the upper slit of the trichame nerve.
	Lower teeth, lower fissure, lower lip, anterior pruritus area.	In case of damage to the lower jaw of the trichamos nerve.
	Wuxia half of the individual	In case of damage to all the hilums of the trigeminal nerve and in the case of a central cause of neuralgia (swelling of the brain is thin).
Blackening of the appearance of the sclera, the development of sleviformation, lacrimation, the appearance of mucus vision from the nose	Qi symptoms are localized on the affected side, they appear during the hour of the pain attack.	Hyperemia and advanced production of sloughing, mucosal salivation and mucus nasal congestion is associated with damage to the autonomic nervous system, which enters the fold of the sensitive fibers of the tricuspid nerve.
Posmikuvannya m'yazіv disguise	M'azovy tremor similar to mild local sudomiy or nervotiki, blamed on aphids pain syndrome. At the same time, that mimic musculature is chewing. It is possible that there is a ringing of the eyelids from a sick side, caused by a spasm of the hips.	Posmikuvannya m'yazіv pov'yazane z reflex extensions of increased alertness on the rough fibers of the trifoliate nerve and other cranial nerves, which are innervated by m'yazi guise. Photo of the patient under the hour of the attack of neuralgia of the trigeminal nerve.
Mental discord	The ailment becomes drastic, they seem to be a little fear, anxiety. If smіh, rozmov, priyom їzhі lead to the development of pain syndrome, ailments zamikaєtsya, mooch, tsuraєtsya їzhi. In important situations, they can be afraid of suicidal insidiousness (bazhannya to end life by self-destruction).	Psychic damage in the ailing person is blamed on the anatomy of partial attacks of unbearable pain, the tremor of illness (rocks), the appearance of attacks and the anatomy of insignificant chinnikov in the trigger zones. Patients show apathy, psychosis, phobias, and depression.
Impaired sensitivity of an individual (paresthesia)	Almost a tingle, a goosebump on the afflicted side. Might show up a dull niuchy bіl, which predicts dental bіl in case of caries and pulpitis (what to bring patients to the dentist). Sometimes one should be aware of the sensitivity of the shkiri under the hour of the triceps nerve.	This symptom develops in a third of patients and sounds like a predictor of the approach of a painful attack (for a few days or a few months to paroxysm). Paresthesia occurs due to the expansion of the myelin sheath of nerve fibers, which leads to the destruction of both sensitivity in the case of advanced excitation and damage to the conduction of the nerve impulse along the sensitive fibers of the nerve.
Impaired blood circulation and lymphatic flow (trophic changes)	asymmetry of appearance, podnyaty kutochok rota (grin), drooping eyebrows, upper brows, strain m'yaziv zі healthy side of the face, dry shkiri, peeling, the appearance of a wrinkle, vipadannya viy, briv, tooth decay (periodontal disease), oblisinnya at the skronevy and frontal dilyantsy, locally thicker hair, weakness of chewing gums.	Trophic damage in the process of the tripartite nerve can be blamed through a sprat of fatal illness. Through the damage to the innervation of the m'yazіv and shkіri veils of the tripartite nerve, thrive and part of the pain attacks, there is damage to the blood flow and struma of the lymph in the affected half of the guise. Tse to bring to destruction the life of fabrics (not enough sourness and life of speeches). In order not to play the trigger zone, the patient should spare the ailment side of the denunciation: live on a healthy beak, don’t laugh, don’t open your mouth wide and so on. It’s time to bring chewing and mimic membranes to atrophy (changes in mucian tissues, decrease in their functions), which is also to bring to destruction the trophy of m'yazyv and shkiri guise. Photo of a patient with atrophy of the face from the right side.

**** Tripartite nerve neuralgia develops from one side and mostly right side. With the passage of the disease, the localization of the pain does not change. Only with severe pathologies of the brain, it is possible to expand the process on the other half of the guise in an hour.

Diagnosis of neuralgia of the trigeminal nerve

A look at a neurologist

1. Anamnesis (history) of life: presence of factors and illness, which could be the cause of neuralgia of the trigeminal nerve (swelling, vascular pathology of the brain, transfer of illness, surgical intervention in the mouth empty or in appearance thinly).
2. History of illness:
   • cob of ailment hostria, raptov, ailments clearly remember if, for some circumstances, the first attack of paroxysmal pain appeared,
   • attack the pain with periods of remission,
   • Pain syndrome provokes a slight irritation of one of the trigeminal nerve trigger zones,
   • one way process
   • pain is not stopped by anti-inflammatory and analgesic methods.
3. Skargi on the attack of acute unbearable pain, which appears raptly after teasing trigger zones, and the appearance of other symptoms of trigeminal neuralgia (indicate more in the table).
4. Objective review during the inter-western period:
   • Zagalny camp sound good, safety is saved, neurotic reactions are possible, the mental state of the sick person is damaged.
   • I'll look around for ailments don't give a damn in the area of ​​trigger zones, he points at them himself, without bringing his finger to the skin or mucous membrane.
   • Shkirnі bend often not change, in case of a severe crippling illness, dryness of the skin, the presence of desquamation, folds and wrinkles, asymmetry of the skin, drooping of the upper lip and other symptoms of atrophy of the skin can be possible. Visible mucous membranes are not changed.
   • Some people are afraid of damage to the sensitiveness of the skin of the face (paresthesia).
     From the side of the internal organs(Cardio-vascular, dichal, herbal and other systems of the body) do not show pathological changes at a glance.
   • Neurological status in patients with trigeminal neuralgia without pathology of the central nervous system, it was not changed. Daily pathological reflexes, signs of inflammation of the meningeal membranes (meningeal signs).
   При патології головного мозку можуть з'явитися ознаки вогнищевих уражень (наприклад, опущення верхньої повіки або птоз, різницю зіниць або анізокорію, симптоми порушення орієнтації пацієнта у просторі, зміна частоти та якості дихання, парез кишечника та інші специфічні неврологічні симптоми ураження середнього та заднього головного brain). . The manifestation of the symptomatology leads to a distant obov'yazykovy іinstrumental obstezhennja mozku.
5. Objective review of the patient during the attack of paroxysmal pain:
   • Bill blames after injection on the trigeminal nerve trigger zone, and the pain syndrome itself expands only along the course of the trigeminal nerve.
   • Patient's posture: zavmiraє chi smeared with hands rozim'yati m'yazi disguise, apologise for energizing chi apologia in short phrases. The ailing person, with whom there is a curse, has that suffering look.
   • On the skies individuals appear pet (pet), red skin of the ailing side of the face and mucous membrane of the sclera, it is possible to drool, ailments are often forged through the elevation of the vision of the line, from the nose, the mucous vision of the “strum” can appear.
   • Pojava judgmental chuckles mіmіchnі m'yazi disguise from one side.
   • Dihannya the ailing is more likely to happen.
   • Pulse often (more than 90 per piece), the arterial pressure does not change, but the troch moves forward.
   When pressing on the trigger points of the trichamoidal nerve, the attack of pain can be timchasovo usunuty.
   
   • When carried out novocaine blockade tricuspid nerve (introduction of novocain along the course of the trichomes of the tricuspid nerve, mainly, ce є ti trigger points), the attack is timchasovo pripinyaєє.

The diagnosis is made on the basis of specific scars, the presence of trigger zones, the localization of pain along the course of the trigeminal nerve, the appearance of visceral symptoms in the hour of attack, an objective look, and these instrumental diagnostics.

Instrumental methods of follow-up

Magnetic resonance imaging (MRI) of the brain and spinal cord
MRI- himself informative method of investigating the structures of the brain, brain vessels, nuclei and fibers of the cranial nerves.

This visual method (which is why it is more accurate than the image on the screen and on paper), however, for the consideration of X-ray methods, MRI is based on magnetic, and not on radiation, imaging. Tobto є bezpechnym for the patient.

In cases of suspected trigeminal neuralgia, MRI is necessary to detect or exclude swelling of the brain, disease of the vessels, the presence of diffuse or diffuse sclerosis, and other possible causes of the development of disease.

For more accurate follow-up of pathologies of the vessels of the brain, MRI is performed from the introduction of contrast speech into the vessels of the brain (angiography).

Disadvantages of the method:

• high variability of follow-up;
• contraindications: the presence of metal objects in the body (remnants of ulama, cadiostimulators, metal plates, which are used for osteosynthesis in case of fold fractures of the bones, metal dentures, crowns), severe psychological illness, claustrophobia.

Computed tomography (CT)

CT– X-ray method of diagnostics, which allows visualizing the structures of the brain and spinal cord point by point. Magnetic resonance imaging is offered for information, MRI chips allow forming a three-dimensional image, and CT - a two-dimensional image. CT allows to reveal disease of the central nervous system, which could lead to the development of trigeminal neuralgia.

The main shortfall of computed tomography is a big change (radiation) of the cost and the road (although the CT method is more accessible and cheaper, lower MRI).

Electroneurography

Electroneurography - an instrumental method for investigating the nervous system, which allows one to determine the speed of conduction of the electrical stream (impulse) from the nerve fibers of the peripheral nerves.

What does electroneurography reveal?

• manifestation of nerve injury,
• rіven hit (tobto de same),
• pathogenesis of injury (shkodzhennya myelin membrane or axon damage),
• the breadth of the process.

What changes can be revealed in case of trichamotor neuralgia?

• demyelination(ushkodzhennya myelinous membrane of axons), as a key factor in the pathogenesis of trigeminal neuralgia,
• other nerve changes characteristic of other nerve injuries that allow differentiation of the nervous system disease

Electroneuromyography (ENMG)

ENMG- A variety of electroneurography, allowing the flexibility of the passage of an electric struma along a peripheral nerve with parallel subsequent reactions of m'yaziv, which are innervated by this nerve.

The cream of quiet parameters, as shown by electroneurography, EMG shows pain tolerance and the threshold of sensitivity of the possible trigger zones of the trigeminal nerve, as well as the steps of the shortness of the m'ulcer fibers in the case of nerve stimulation.

Electroencephalography (EEG)

EEG- a method of diagnosing the nervous system, for which a special device, an electroencephalograph, registers the biological electrical activity of the brain, depicting them in the visual curves. This method allows you to reveal structures that disrupt the passage of impulses.

What is observed in EEG for a paroxysmal attack of trigeminal nerve neuralgia?

• change curves for synchronized or non-synchronized type,
• signs of epileptic pits in the posterior and middle cerebellum, in the areas of rotting of the nuclei of the trigeminal nerve.

Additional consultations of higher education specialists in trigeminal neuralgia

• ENT - it is necessary to detect, if necessary, to treat chronic congestion of the nasopharynx.
• A neurosurgeon - in case of revealed pathology of the central nervous system, which could lead to the development of neuralgia, it is necessary to overcome the need for surgical treatment.
• Dentist - for differential diagnosis of trigeminal neuralgia due to diseased teeth and, if necessary, sanitation of empty mouth.

Laboratory methods

In case of trigeminal neuralgia, laboratory diagnostics is not very informative; To date, there are no specific laboratory findings that indicate neuralgia, notably, including trigeminal neuralgia.

And on the background of taking medications for the treatment of neuralgia, it is necessary to control your tolerance. For this, periodically conduct a biochemical study of the liver, a deep analysis of the blood section.

For the presence of symptoms of inflammation of the meningeal membranes (meningeal signs), it is necessary to perform a spinal puncture with further laboratory findings of the cerebrospinal fluid (spinal cord). It is necessary for the exclusion of meningitis.

In case of herpetic lesion of the trigeminal nerve, it is necessary to control the level of immunoglobulins A, M, G to herpes I, II, III types.

Triple nerve neuralgia

Treatment of trigeminal neuralgia may be complex:

• usunennya reasons that provoked the development of trigeminal neuralgia.
• change in the alertness of the central nervous system;
• The stimulants of the miLіnovo shells of the rush -frequent nerve - at Denmark of the moment of the Unded, the alloy is allowed to be all -toed, considerable, over the rodbone of such an ethnic drug, praziyu, Ale to get used to the restaurant of the restaurant;
• physiotherapeutic injection on the trichomes of the trichamoidal nerve and trigger zone.

Medical treatment of trigeminal neuralgia

Group of drugs	A drug	Mechanism dії	How to stop?
Anti-seizure drugs(Treatment of the drug and yoga doses should be carried out individually)	Carbamazepine (finlepsin)	Effects when taking anti-seizure drugs: protiepileptichny, psychotropic effect, stopping and reversing the attack of pain in case of neuralgia of the tricuspid nerve. Golovna їhnya diya - tse stabilization of sodium-potassium channels of the axon membrane, which transmit nerve impulses. For this reason, the alertness of the nerve fibers of the trifrequent nerve and nuclei in the middle and posterior vertebrae of the brain changes. Other effects: inhibition of glutamate (neurotransmitter, which stimulates the galvanization of the nerve impulse) and inhibition of the formation of neurotransmitters, which stimulates the stimulation of nerve fibers (dopamine and norepinephrine). Respect! Anti-diabetic drugs are considered to be psychotropic medicinal products and may have a lot of side effects, which is only allowed in pharmacies with a doctor's prescription.	The drug is gradually administered from small doses, then more dosing. Begin treatment with 100-200 mg of binary per doba, then bring up to 400 mg of dual-tricha per doba until pain attacks are applied. Later, you can change the dose of the liquor effect up to 100-200 mg 2 times a day. Trivale jubilation.
	Phenytoin (difenin)		Start with a dose of 3-5 mg per kg per doba, then increase the dose to 200-500 mg per doba. The dose is taken one time or adjusted for 2-3 doses, only after or after an hour. Trivale jubilation.
	Lamotrigine		Pochatkova dose - 50 mg 1 time per doba, then the dose is adjusted to 50 mg 2 times per doba. Trivale jubilation.
	Gabantine	The mechanism of action of this drug is not known, experimentally it has been shown to be highly effective in trigeminal neuralgia.	Pochatkova dose - 300 mg per doba, maximum 1800 mg per doba. The drug is taken for 3 doses.
	Stazepin		Cob from 200 mg per doba, increase the dose to 600 mg per doba. Take for 3 take.
Muscle relaxants	Baclofen (Baclosan, Lioresal)	Baclofen is effective for the treatment of neuralgia, for the stimulation of the release of the neurotransmitter GABA (gamma-aminobutyric acid). Effects of stasis of muscle relaxants: galvanization of the alertness of nervous cells, change in the tone of m'yaziv, pain-relieving day.	Initially, the dose is 15 mg for 3 doses, then progressively increase to 30-75 mg per dose for 3 doses.
	Mydocalm	stabilizing sodium-potassium channels of the axon membrane, spryaє galvanization of the passage of nerve impulses along the nerve fibers, pereskozhaє passage of calcium in the synapse, improve the blood circulation of the head, may have a soothing effect	The usual dose is 150 mg per doba in 3 doses, the maximum dose is 450 mg per doba in 3 doses.
Vitamin preparations	Vitamins of group B (neuromultivit, neurovitan and other complexes)	antidepressant diya, reducing the unfriendly influx of external factors on the nervous cells, taking part in the processes of step-by-step replacement of myelin sheaths of axons and many other effects, both peripheral and central nervous system.	1 tablet 3 times per meal.
	Non-essential fatty acids Omega-3 (dietary supplement)	Non-essential fatty acids as a material for myelin.	1-2 capsules per doba with meals.
Antihistamine drugs	Diphenhydramine, pipalfen	Pіdsilyuyut dіyu protizudomnih predavіnіv.	Diphenhydramine 1% 1 ml before bed at night, Pipalfen 2.5% - 2 ml at bedtime as an injection.
Sedative and antidepressant drugs	Glycised (glycine)	Glycine is an amino acid that is a neurotransmitter that galvanizes the process of stimulating the nervous system. May calm, anti-stress, normalize sleep.	2 tablets 3 times for doba rozmoktuvati, pіd yazyk.
	Aminasin	Aminasin blocks receptors that receive impulses from nerve fibers. Zavdyaky this drug may have a calming effect and change psychotic reactions in acute and chronic psychoses.	20-100 mg skin for 4-6 years internally. Injection administration is not necessary for acute psychotic reactions. Inject 25-50 mg once, if necessary, re-administer the drug. Taking the drug is continued until the normalization of the mental state becomes ill.
	Amitriptyline	May be an antidepressant drug for the regulation of neurotransmitters.	Initial dose: 75 mg in 3 doses, then increase the dose to 200 mg in 3 doses. The drug is recommended to be taken for an hour or so.

In severe cases of trigeminal nerve neuralgia, constant pain, it is recommended to induce narcotic drugs (sodium oxybutyrate, cocaine, morphine).

Previously, the blockade of the triceps nerve with 80% ethyl alcohol (alcoholization), glycerin and novocaine was widely used. However, at the present time, it has been proven that, regardless of the short painful effect, these procedures can combine additional traumatization and destruction of the myelin sheath of the trigeminal nerve, which could (already through pivroku) lead to the progression of contraction with short strokes.

Obov'azkovo conduct the correction of quiet states, yak, perhaps, brought to the development of illness:

• examination of ENT pathology,
• therapy of sudinnykh zahvoryuvan brain,
• adequate sanitation of the empty mouth,
• antibacterial (or anti-rusne) and immuno-corrective treatment of infectious diseases,
• prevention of the growth of healthy tissue (scarring) after injuries, surgical treatment and infectious processes, for which effective recognition of biostimulants (aloe extracts, placenta, FibS), short courses in small doses of glucocorticosteroids (hormones) and physiotherapy procedures,
• normalization of the exchange of speech, with yogo disorders (diet, vitamin therapy, correction of the hormonal background thinly),
• otherwise come in, fallow due to causal illnesses and conditions.

Surgical treatment for trigeminal neuralgia

It is recommended to promptly treat trichamotor neuralgia, as it is more effective to overcome problems with minimal risks of postoperative complications. Also, to promote easier surgical manipulations for the duration of the clinical effect in the form of drug therapy (after 3 months of positive results).

1. Operative solution of problems that caused neuralgia:
   • removal of the tufts of the brain(depending on the operation depends on the type, localization and breadth of the puffy process),
   • microvessel decompression- Placement or resection (removal) of the expanded vessels, as if to squeeze onto the tripartite nerve or the third nucleus,
   • extension of the sounded foveal canal(Miss exit of the tricuspid nerve) - low-traumatic surgery on the bones of the skull.
     With an effective diagnosis of reasons that caused compression of the trigeminal nerve, often attacks of trigeminal neuralgia pass, the result is a contraction.
2. Operative insertion, directing to the change in the conductance of the trifrequent nerve:
   • Cyber ​​Nizh- Modernly effective treatment of neuralgia of the tricuspid nerve. When tsimu on the vіdmіnu vіd іnshih traumatic operations, the risk of development is minimal (average 5%). Cyber ​​Nizh is a special type of radiosurgery that does not affect punctures, surgeries and other manipulations that injure. It is possible to carry out the posture by the inpatient clinic (outpatient).
     This method is based on the influx of a thin exchange of radiation vibrance for a dilatation of increased excitability of the nerve fibers of the trigeminal nerve or of the th nucleus.
   • Gamma Nizh yak і Kіber Nіzh - a method of radiosurgery, with which beams of radiation vibrance destroy the tripartite ganglion. Also, a low risk can make the development easier. For its effectiveness, Cyber ​​Nizh is used.
   • Balloon compression of the ternary ganglion - a catheter is inserted through the scruff into the region of the node of the trifoliate nerve, through which a balloon is installed and it is repeated. This balloon is squeezing the ganglion, roaming the trichomes of the nerve, thereby usuvaє conduction of nerve impulses in the central nervous system. This method has a temporary effect and can lead to a development of complexity (the names of individuals, the distortion of facial expressions, the violation of the act of chewing).
   • Resection of the ternary ganglion- folding traumatic operation, as it will require trepanation of the skull, removal of the ganglion with a path of hanging with a scalpel and a trivial post-operative inspiration, as well as a high risk of development is complicated.
   • Other types of surgical operations, straightening on the thoracic ganglion or the triceps nerve are traumatic and often give relief.

Choose the method of surgical treatment to deposit in:

• the possibilities of medical mortgage and surgeons,
• financial capacity of the patient (methods of radiosurgery are expensive),
• the presence of concomitant illnesses,
• I'll become a hot-headed patient,
• the reasons that led to the development of neuralgia,
• presence of individual indications and contraindications to the first type of operations,
• the patient's response to medication treatment,
• the risk of development of post-operational complications is too thin.

Physiotherapy for trigeminal neuralgia

Physiotherapy– effectively come in for the treatment of pain syndrome in case of neuralgia of the trigeminal nerve. Depending on the stage of the injury, the frequency of relapses, the causes that caused neuralgia, prescribe the most effective method of physical injection on the tripartite nerve or the third nucleus.

Methods of physiotherapy

Method	effect	principle to method	Trivality of glee
Ultraviolet reflection (UVI) of individuals of that shi	Understanding the pain syndrome.	Ultraviolet oprominennia (and the middle one itself) sprays the viability of neurotransmitters, which galvanizes the excitation of nerve fibers and natural analgesics.	10 sessions
Laser therapy	Relief of pain syndrome, galvanization of the conduction of a nerve impulse from the nerve fibers of the trigeminal nerve.	The laser is used to infuse the areas of localization of the cutaneous hilum of the trifoliate nerve, and to induce the nodes that have been created by this nerve. Laser oprominennya to rot the sensitivity of nerve fibers.	Zagalom recommend 10 procedures for 4 hvilini.
UHF	Zyattya pain attack, polypshenya microcirculation with atrophy of mimic and chewing mucus.	Injection with ultra-high frequencies spryaє: the energy of the fabrics of the wounded peasants, which manifests itself in the sights of them of heat, polypshenya blood circulation, lymphatic strum, frequent normalization of sodium-potassium channels in the membrane of nerve fibers that transmit nerve impulses.	15-20 sessions of 15 quills
Electrophoresis	Painful effect, relaxation of the mind.	Electrophoresis - the introduction of medicinal speeches for the help of an electric stream without intermediary at the necessary nerve nerve. To relieve pain, inject: novocaine, diphenhydramine, platyphilin. Speech blocks block potassium-sodium channels, thus preventing the transmission of nerve impulses by the nerve. Also, for additional electrophoresis, vitamins of group B can be introduced to improve the eating of the nerve and the damaged myelin membrane.	Number of procedures is shorter than other methods of physiotherapy every other day, less than 10 procedures.
Diadynamic streams	Painful effect, decrease in the intensity of pain in the onset of paroxysmal attacks, podovzhennya periods of remіsії.	For this method, vicorists are streaked by Bernard, yakі є electric strums with an impulse of 50 thousand hertz. The electrodes are installed in the area of ​​the trigger zones of the trigeminal nerve, including the nasal mucosa. Bernard's strum lowers the threshold of pain sensitivity, blocking the trichomes of the nerve, thereby reducing the intensity of the pain syndrome to the point of total pain. Efficient stasis of diadynamic strums in patients with electrophoresis and other methods of physiotherapy.	Dekіlka courses for 5 days with a break of 5-7 days, the procedure lasts 1 hvilin.
massage	Prevention and treatment of atrophy of mimic and chewing malignancies.	Masazh m'yazіv guise, head and shiї improve krovoobіg i strum lymph, thereby improving your eating. The massage should be carried out carefully, it is not the fault of the trigger zones and provoke the development of pain attacks. Vikoristovuyut ruhi stroking, rubbing, vibrating. The course of massage is prescribed only against the background of a stable remission of illness.	10 sessions.
Holcoreflexotherapy (acupuncture)	Understanding the pain syndrome.	Acupuncture is injected into nerve receptors, which transmit impulses to nerve fibers. When choosing, choose a sprat point near the trigger zones and a sprat point in the distance on the lengthwise side. Sometimes the goals are set for a three-year period - you will get more, periodically scrolling.	The trivality of jubilation is chosen individually, often there are only a few procedures.

All physiotherapy methods are due to zastosovuvatisya in combination with drug therapy and the use of factors, which led to the development of an illness, oscalki as monotherapy (mono-one) physical procedures are powerless.

Prevention of neuralgia of the triple nerve

1. At the same time, the animal for medical assistance for the treatment of hospitals and chronic diseases of the ENT organs, proper sanitation of the oral cavity empty.
2. Secondary preventive medical look around with the method of revealing diseases of the internal organs, endocrine diseases, nervous and cardiovascular pathologies.
3. Unikati injuries rebuke that head.
4. Unique stretching and other types of hypothermia.
5. Controlling arterial pressure and treatment of hypertensive ailments, vegetative-vascular dystonia, atherosclerosis and other vascular diseases.
6. Healthy lifestyle:
   • total physical activity,
   • povnotsinny dream and vіdpochinok
   • adequate response to stressful situations,
   • it is more correct to eat healthy food, so that you can get enough vitamins, microelements, non-essential fatty acids and amino acids.
   • zagartovannya,
   • vіdmova vіd kurinnya, zlovzhivannya drugs and alcohol and more.
7. Can't engage in self-admiration pain in the area of ​​appearance, remember that whether or not manipulations can help overcome trigeminal neuralgia.

Be healthy!

Inflammation of the tripartite nerve - ce disease of one of the largest nerves, scho znahoditsya in the field of teeth that appearance.

Doctors have already been treated for ailments at home for a long time, but if they do, they can’t come up with a single solution: it’s better to treat this ailment and how you can vilify.

Varto rose, why are you sick. It is important that hypothermia itself is the cause of the inflamed tricuspid nerve, but do not forget about other factors, so that the development of the ailment can be taken. and itself:

• virus or infection;
• inflammation of the brain, woo;
• pain relief of the nerve under the hour of seeing a dentist.

Use also 2 see fire tripartite nerve, first and second:

1. Primarily ignited- ill, as if blamed for hypothermia, with no daily changes in the head.
2. BUT second fire may be in case of brain disease or ENT - organ.

Before the main symptoms of inflammation of the trigeminal nerve be seen:

• ruined taste;
• sharp attack pain;
• disruption of the normal functioning of the eyes, wow;
• ruined ruins of an individual;
• zbіshuєtsya or zmenshuєtsya slozovidіlennya;
• paralysis m'yaziv guise.

Diagnosing illness is easy to do, because it is powerfully clear-cut symptoms, which can be easily confused with symptoms characteristic of other types of illness.

In order to reconsider and confirm your diagnosis, doctors can recognize such obstezhennia as CT.

Likuvalni procedures

The old fates of jubilation were practically impossible, for that which was unreasonable as a lure of inflamed triple nerve.

Right now rozroblenno different options treatment of neuralgia of the tricuspid nerve

However, stinks often super-speak one to one.

The type of healing in case of inflammation of the trifoliate facial nerve is selected by the doctor, depending on the intensity of inflammation, the term of your illness and other reasons, but mainly jubilation in all moods, the exaltation of pain attacks will be straightened out.

The main drug, which zastosovuєtsya with lіkuvannі inflammation of the tripartite nerve - tse.

The drug is prescribed only by a doctor and is individually selected for the skin patient.

Initiate the drug in 2-3 days, beware of pain relief. Trivalіst nebolyuvannya becomes in the middle 3-4 years.

Dosing of carbamazepine, in which case the patient can calmly take it, then take it for a month. After a month, the doctor may consider continuing the course or gradually reducing the dosage of the drug.

Treat with carbamazepine inflammation of the trichic facial nerve try doti, the docks by the patient will not be recognized again by the number of attacks

In his own line, he develops both etiotropic therapy, as if fighting against the cause of illness, as well as complex approaches necessary for the assimilation of pain symptoms. What is assigned medicinal treatment inflamed tricuspid nerve, zastosovuyt also other tablets.

Have your own line of etiotropic therapy directions to:

1. When the viral nature of the infection is revealed, the following drugs are prescribed: laferon, herpevir, acyclovir and others.
2. If an aneurysm is detected, or if it is fixed in the vessels, an operation can be performed to remove the damaged parts.
3. In case of pink sclerosis, preparations are needed to regenerate the myelin sheath of the nerve.
4. To improve the exchange of speech in nerve tissues and to eliminate cholesterol plaques, vicorist preparations are used to reduce cholesterol levels. Tse mozhe buti atoris or rosuvolostatin.

To change the intensity of pain attacks, different faces are prescribed pharmacological groups:

1. Painful and non-steroidal anti-seizure agents, for example: nіmesil, analgin, ketanіv. Ale stinks dopomagayut leash on the cob attack.
2. In the case of sick people, they can vicorist sedative drugs to increase their efficiency. For example, taking diphenhydramine and analgin significantly changes the intensity of pain. Side effect: drowsiness.
3. Anti-seizure drugs Yak karbamazepim vikoristovuyut to reduce the pulsation of nerve tissue. Have their cherga can vyklikati drowsiness.
4. Opiatnі anesthetics(that's similar to morphine) can also zastosovuvatisya in connection with their high pain-inducing effect. Ale through їhnyu narcotic diyu zastosovuetsya, only if other preparations do not help.

There is also a great number of ways to exultation inflamed by folk zasobami, for example:

• cibula juice;
• compress from teapot and lemon juice;
• tincture of propolis.

Ale outside the jubilation of the people’s ailments, the people’s health cannot be guaranteed;

Possibly folded

If the tripartite nerve is inflamed, problems can be caused in looking uncomfortable.

Tse mozhe buti viklikana wrong exultation, self-exaltation or other factors.

Up to the main complication like this:

• weakening of the dry functions of facial skin;
• disruption of the normal functioning of the hearing organ;
• hematoma of the cerebellum;
• Ataxia, to disrupt the coordination of movement.

Tsі ukladnennya stand up to us in front of the singing groups of the population. Tse nasampered people of a poor age, the bones of their immunity and health are weaker, lower in other people, so the stench is more sick to the point of getting sick.

Tsі ukladnennya hustle and people, yak watch out for disruption of speech exchange otherwise they suffer from vessel-heart disease.

Forecast

Forecast, delivered by the doctor, may lie due to various factors.

In the main wines lie in the eye of the patient, the nature of the disease, or it can be transferred by disease, tied to the vessels and the nerves of disguise. Well, obviously, as the patient is young, then the exuberance is quick and without further relapses.

On the vіdmіnu vіd vіdnіkh patsієnіv, for such neuralgіv, pov'yazan z broken exchange processes in the body, unfortunately, don't be fooled into vilіkuvati.

Preventive visit

Everyone sees that it’s easier to avoid illness, less to enjoy yoga. In his blackness, there is a burning and inflamed tripartite nerve.

From the very beginning cost a fight about elementary speeches like a daily routine and a healthy way of life. It didn’t sound trite, but an adequate daily routine and a side dish of eating will help impersonal illnesses.

Years of people, yakі not dієti most skhilnі to atherosclerosis, which is the cause of neuralgії.

Obov'yazkovo it is necessary to uniquely overcool that is the main reason for the fuse.

It’s better for him to dress up better in cold weather, so that the distant one doesn’t get sick of these diseases.

Obov'yazkovo listen to different symptoms and rejoice at the same time to different respiratory illnesses.

As soon as you have symptoms of inflammation of the trigeminal nerve, you should immediately turn to the doctor and follow up on all the recommendations for a proper diet and way of life.

I, obviously, at any time do not varto engage in self-admiration otherwise check the docks neuralgia will pass by itself. What do you do better than you see likuvannya, then you can be the heirs.

Video: Tripartite neuralgia

Details of the inflammation of the tripartite nerve. De-rotting the inflamed cavity, as symptoms and pain syndromes point to trigeminal neuralgia.

Often the patient has to go through a lot of doctors, first of all, more specific treatment, as they prescribe him a doctor -. Before this, it is necessary to perekonatisya in that which you are defiantly blaming spontaneously, and not be provoked by an obvious cause, for example, a plump empty skull. After different views, the middle of which may be MRI, ultrasound of the vessels of the brain, head, neck, electroencephalography, if a neurologist prescribes a cure.

Carbamazepine is the basis of neuralgia therapy

The basis of therapy for trigeminal neuralgia is the use of carbamazepine and other anti-seizure drugs (for example, lamotrigine). Alone, carbamazepine () is the current basis for the treatment of neuralgia as a triple, and other nerves ( , ) and many other localizations.

Same with carbamazepine, a jubilant process begins. It is necessary to say that this drug is weaker: it will make you feel more light without attacks of pain, and you will soon attack sickness yourself.

It is important to know that the mechanism of the development of pain is such that carbamazepine, as well as other preparations for any illness (and for neuralgia of other localizations), do not slacken so that it changes. Bil is the same zhorstoy, as if without likuvannya, the scarlet pain is less, and the wine is short.

The mechanism of action of carbamazepine can be removed from the fences, as if they were placed in the presence of an avalanche. Most of the time, the stench is ahead of the “snowball”, but if you have made yourself guilty, then the avalanche is inevitable. And yet, on the same mountain, Skoda in the presence of avalanches becomes noticeably smaller and minimal.

How to take carbamazepine for trigeminal neuralgia?

The standard dosage of this drug is 200 mg per tablet. Exchange for kіlkіstyu - 2 tablets 3 days a day. Further increase in the concentration of the drug in the blood should no longer be carried out until improvement, there is a risk of side effects.

The side effects of high doses of carbamazepine (Finlepsin) can lead to the attack:

• Periodic weakness, drowsiness;

• Zmina smakovih zvichok;

• Allergic reactions.

In addition, this drug improves the reaction time from the cause, through the yak vin ryatuє in the pain: the "stability" of the neurons is improved, it does not allow them to reduce not only the pain discharge, but also the korisny signal singing. roboti.

In order not to blame similar side effects when taking carbamazepine, an individual dose selection is required. The smut rule is not to recognize high doses, otherwise side effects can be even more pronounced.

As a rule, 200 mg (one tablet) is administered on the cob, and then the dose is increased twice until the effect is reached. Admittedly, the effect, which manifested itself in the changed age of attacks in the middle and in the style of the times, increased “bright gap”, was achieved in a dose of 600 mg, that is one tablet of trichi per day.

Then we begin to reduce the amount of 14 tablets (50 mg) of the dose. The minimum dose, if a good effect is obtained, and you will increase the therapeutic dose of this drug.

Sometimes the dose can be changed significantly. As a rule, it is associated with the use of adjunctive drugs and drugs: antidepressants (serotonin serum inhibitors), drugs for the treatment of neuropathic pain (gabapentin) and other drugs.

Use retard (Carbamazepine retard, Finlepsin Retard) or prolong the form of carbamazepine. This is the name of the faces, in which speech the language vibrates properly and finishes the trival hour. As a result, the interval between taking the drug is increased, the risk of seizures is reduced, and the vindication of the "overnight attack" is reduced, the patient's acceptance of the drug is greater.

In addition, when switching to the retard form, the “smooth curves” of the concentration of speech in the blood plasma showed a significant decrease in the development of side effects.

21521 0

Carbamazepine
Normotimics, protiepileptic diseases

Release form

Syrup 100 mg/5 ml
Tab. 200 mg, 400 mg
Tab. prolongation action 200 mg, 400 mg

Mechanism dії

The mechanism of action of carbamazepine induction from the blockade of sodium channels in the membranes of hyperactive nerve cells, which leads to the stabilization of the membrane of neurons and, therefore, changes the development of the potential for action in response to the nerve impulse. Blockade of sodium channels of presynaptic galmuic membranes leads to the development of mediators and suppresses the synaptic conduction of nerve impulses. Carbamazepine reduces the influx of excitatory neurotransmitter amino acids (glutamate, aspartate) and increases the activity of galmic (GABAergic) processes. Ignores the metabolism of dopamine and norepinephrine, influencing the activity of potassium and calcium channels.

Main effects

■ Building pressure analgesic in patients with neuralgia.
■ In case of essential and secondary neuralgia of the tricuspid nerve, the majority of seizures in carbamazepine are ahead of the development of pain attacks. Relief of pain in case of neuralgia of the trigeminal nerve is indicated in 8-72 years. Carbamazepine is an edible reduction in neurogenic pain.
■ Repair also normotimic and anti-maniacal deeds.

The cob of anti-sumoral effect varies from a few years to a few days (sometimes up to 1 month after autoinduction of metabolism). Antipsychotic (anti-maniacal) develops in 7-10 days, which may be associated with an impact on the metabolism of catecholamines.

Pharmacokinetics

Absorption is povilna, ale povna (priyom їzhі suttєvo not vplyvaє on shvidkіst that stupіn vmoktuvannya). After a single oral tablet intake, the maximum plasma concentration of carbamazepine is reached after 12 years.

After a single dose of an intravenous tablet, to take 400 mg of carbamazepine, the average maximum concentration of unchanged active speech becomes close to 4.5 mg / l (with the retard form - 25% lower). The hour to reach the maximum concentration is 1.5 years for taking suspensions, 4-5 years for taking tablets, and for the prolonged dosage form in viglyad capsules - 5-9 years, for tablets with upgraded vilifications - from 3 to 12 years. The retard form allows to reduce the additional coagulation of the plasma level, the concentration of LZ; at which point the absolute decrease in the minimum value of an equally important concentration is not indicated. Equal plasma concentrations of carbamazepine are reached after 1-2 days.

It is easy to reach due to individual peculiarities of metabolism (autoinduction and / or heteroinduction of enzyme systems of the liver and in, influencing the metabolism of one-hour stasis of LZ), and also in case of becoming ill, doses of LZ and trivality of treatment. There are reasons for the differences between the values ​​of concentrations of equal importance in the therapeutic range: in most diseases, the values ​​fluctuate from 4 to 12 mcg/ml (17-50 mcmol/l). The concentration of carbamazepine-10,11-epoxide (pharmacologically active metabolite) becomes close to 30% of the concentration of the unchanged LZ.

The binding from plasma proteins in children is 55–59%, in adults it is 70–80%. It is given a total dose - 0.8-1.9 l / kg. In the spinal cord and the line, the concentrations are proportional to the amount not associated with LZ plasma proteins (20-30%). Carbamazepine crosses the placental barrier. The concentration in breast milk becomes 25-60% of that in plasma.

Carbamazepine is metabolized by the monooxygenase system of the liver with approved metabolites, the main ones being: active carbamazepine-10,11-epoxide and low-activity 9-hydroxy-methyl-10-carbamoylacridan. The head isoenzyme, which ensures the metabolism of carbamazepine, is cytochrome CYP3A4. Carbamazepine, building, induces low cytochrome P450 isoforms: CYP3A4, CYP3A5 and CYP3A7, incl. induction and enzymes of wet metabolism, quicker yoga (autoinduction).

T1 / 2 after a single internal intake - 25-65 years (in the middle, close to 36 years), in the process of treatment, the period becomes short (12-29 years) depending on the duration of the completed course of therapy after autoinduction of the monooxygenase system of liver enzymes. In patients who are able to eliminate additionally anti-sudominal LZ, to induce enzymes of the monooxygenase system (phenytoin, phenobarbital), T1 / 2 of carbamazepine shortens in the middle to 9-10 years.

Following a single oral dose of 400 mg carbamazepine, 72% of the administered dose is excreted orally and 28% is excreted in the feces.
In children with high elimination of carbamazepine, it may be necessary to inject more high doses of LZ with rosemary per 1 kg of body weight compared with adults.

There is no evidence to suggest that the pharmacokinetics of carbamazepine change in patients of the frail age.

Indication

■ In case of pain syndrome of neurogenic genesis: pink sclerosis, acute idiopathic neuritis (Guyenne-Barre syndrome), diabetic polyneuropathy, phantom pains, syndrome of "strained legs" (Jekbom's syndrome), hemifacial spasm, posttraumatic spasm., posttraumatic spasm.
■ For the prevention of migraine.
■ In case of epilepsy (because of absences, myoclonic attacks or attacks).
■ In case of idiopathic neuralgia of the trigeminal nerve, neuralgia of the trichaminal nerve in case of rosaceous sclerosis (typical and atypical), idiopathic neuralgia of the linguo-pharyngeal nerve.
■ With diabetic neuropathy with pain syndrome.

Method of stosuvannya that dose

Carbamazepine is taken internally, independently from each other, together with a small number of natives.

Retard tablets (a whole tablet or half) should be slid down, not rotting, drinking down a small amount of water. In some ailments, with vicarious retard tablets, the need to increase the dose of LZ can be blamed.

In case of neuralgia of the trigeminal nerve on the first day, carbamazepine is prescribed at a dose of 200-400 mg per doba, gradually increase the intake, but not more than 200 mg per doba, right up to the pain (on average 400-800 mg per doba), and then change to the lowest effective dose. In case of pain syndrome of neurogenic origin, the dose is 100 mg 2 r / doba on the first day, then the dose is increased by more than 200 mg / day, if necessary, it is increased by 100 mg of the skin for 12 years until the pain is relieved. The intermediate dose is 200-1200 mg per doba per sprat.

When treating ailments of a frail age and ailments with increased sensitivity, the dose of the cob should be 100 mg 2 r / dobu. Children - 10-20 mg / kg per doba for a sprat of ingestion.

Contraindication

■ Hypersensitivity to carbamazepine or similar to chemical buds (for example, tricyclic antidepressants).
■ Impairment of cystic cerebrovascularization (anemia, leukopenia).
■ Gostra "transient" porphyria (including history).
■ Atrioventricular block.
■ Vagity (I trimester).
■ One-hour administration of monoamine oxidase inhibitors and lithium preparations.

Prevention, therapy control

Before the recognition of carbamazepine and in the process of treatment, it is necessary to follow up the function of the liver, especially in patients with a history of some cases of liver disease, as well as in patients of a frail age. In the case of more severe liver dysfunction, or in case of active liver disease, carbamazepine should be negligently indicated.

Before the spadix, it is necessary to carry out a follow-up blood picture (including thrombocytopenia, reticulocytes), concentration of saliva in the blood serum, cross-sectional analysis of the cross section, concentration of the sechoin in the blood, electroencephalograms, determination of the concentration of blood clots. In the course of the year, the signs of the next control: protracted the first month of the first month of jubilation, then schomisyatsya.

Carbamazepine is responsible for some of the negative effects in the development of allergic reactions.

Before the spadix, it is recommended to carry out ophthalmologic obstezhennia, including the follow-up of the internal bottom and reconciliation for the need for an internal squeeze. In times of admission to carbamazepine, patients with advanced internal pressure need a permanent control of this symptom.

We should take into account the possibility of activation of psychosis, which latently proceed, and in patients of a frail age - the possibility of development of disorientation or awakening when receiving LZ.

It is necessary to bring to the attention of patients information about the early signs of toxicity to carbamazepine, which indicate hematological damage, as well as about the symptoms of cervical curvature of the liver.

The patient is informed about the need to go to the doctor in case of such undesirable reactions, such as fever, sore throat, visip, mucous membranes of the empty mouth, unreasonably called "bruises", hemorrhage in the appearance of petechia or purpura.

In the majority of depressions, there is either a decrease in the number of platelets and/or leukocytes, not as a cause of aplastic anemia, or agranulocytosis.

Non-progressive asymptomatic leukopenia does not affect symptoms, prote with the appearance of progressive leukopenia or leukopenia, which is accompanied by clinical symptoms of infectious disease, mild spondylitis.

Inhibitors of monoamine oxidase are due to blame only less than 2 days later, which allows the clinical situation to be called for a larger term to the cob with carbamazepine.

Carbamazepine in the prolonged form can be taken as a single dose for the night.

The need to increase the dose for an hour is very rare when switching to retard tablets.

Information about bleeding in women during periods between menstruation in depression, if oral contraceptives and carbamazepine were concurrently stopped. Carbamazepine can negatively affect contraceptive pressure, so women of reproductive age should consider alternative methods to prevent pregnancy.

In women of reproductive age, carbamazepine is responsible for its ability to be used as monotherapy (vitaminum is the least effective dose), because the frequency of congenital anomalies in newborns, born by women, which was carried out combined protiepileptic treatment, more, lower in quiet, who took away the skin from cih LZ in viglyadі monotherapy.

If the nutritional status of carbamazepine is recognized during pregnancy (especially in the first 3 months), it is necessary to seriously assess the progress of therapy and possibly complicate it. It seems that children, like mothers, who suffer from epilepsy, are sick to the point of destruction of intrauterine development, including vadi development. Patients may be given information about the development of the disease and the possibility of undergoing antenatal diagnosis.

As a method of preventing advanced bleeding, they are not able to remain vaccinated in the rest of the year, and it is also recommended for newborns to take vitamin K.

Carbamazepine penetrates into breast milk, and there are consequences and possible consequences of breastfeeding in the minds of therapy, which is possible. Mothers who take carbamazepine can breastfeed their babies for a wash so that the baby will be alerted to the development of possible side reactions (for example, drowsiness, allergic reactions).

During the period of rejoicing, it is necessary to take care when caring for vehicles and / or employment with other, potentially unsafe types of activity, which will increase the concentration of respect and the flexibility of psychomotor reactions.

Do not stop using carbamazepine to relieve severe pain, or as a preventive measure in the period of remission in case of trigeminal neuralgia.

I would like to acknowledge:
■ with latent psychoses, inadequate response to external stimuli, arousal;
■ in case of illness, which are characterized by convulsions of a mixed nature;
■ for the presence in the anamnesis of illness of the heart, liver of the worker;
■ with hematological disorders;
■ with a raised internal vice;
■ with hyperplasia of the anterior ridge;
■ we are sick of a frail age;
■ Patients whose work is connected with the operation of mechanisms, caring for motor vehicles.

Side effects

Dose-dependent side reactions may take place over a period of several days, either spontaneously or after a time-limited reduction in the dose of carbamazepine. The development of side reactions from the side of the central nervous system can be the result of a significant overdose of LZ and significant levels of active speech in plasma. In such cases, regular monitoring of plasma concentrations of carbamazepine is recommended.

From the side of the nervous system:
■ more often - confusion, ataxia, drowsiness, asthenia;
■ often - headache, accommodation paresis; sometimes anomalous mimotile fluctuations occur (for example, tremor, "fluttering" tremor - asterixis, dystonia, tics); nystagmus;
■ Rarely - orofacial dyskinesia, paresthesia, malocclusion, movement disorders (for example, dysarthria), choreoathetoid disorders, peripheral neuritis, paresthesia, myasthenia gravis, and symptoms of paresis.

From the side of the mental sphere:
■ Rarely - hallucinations (zorovі chi hearing), depression, decreased appetite, restlessness, aggressive behavior, awakening, disorientation;
■ more rarely - activation of psychosis.

Allergic reactions:
■ often - kropiv'yanka; inodi - erythroderma;
■ rare - wolf-like syndrome, sverbіzh shkіri; rarely - exudative erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), photosensitivity.

From the side of the blood system:
■ more often - leukopenia; often - thrombocytopenia, eosinophilia;
■ rarely - leukocytosis, lymphadenopathy, folic acid deficiency;
■ more rarely - agranulocytosis, aplastic anemia, right erythrocytic aplasia, megaloblastic anemia, gostra porphyria, which "intermittent", reticulocytosis, hemolytic anemia.

■ even more often - nudity, vomiting;
■ often - dry mouth;
■ inodі - diarrhea or constipation, bіl in the stomach;
■ rarely - glossitis, stomatitis, pancreatitis.

On the side of the liver:
■ more often - increased activity of y-glutamine transferase (due to induction of this enzyme in the liver);
■ often - increased activity of pool phosphatase;
■ іnоdі - increased activity of hepatic transamіnases;
■ Rarely - cholestatic hepatitis, parenchymal (hepatocellular) or mixed type, zhovtyanitsya;
■ rarely - granulomatous hepatitis, liver failure.

■ rarely - damage to the internal heart conduction;
■ more rarely - bradycardia, arrhythmia, atrioventricular blockade with non-obstructive camps, collapse, worsening or development of chronic heart failure, acute ischemic heart disease (including the appearance or frequent attacks of angina pectoris, thromboembolism), thromboembolism

■ possible dyspnea, pneumonia.

From the side of the endocrine system and the exchange of speeches:
■ часто – набряки, затримка рідини, збільшення маси тіла, гіпонатріємія (зниження осмолярності плазми внаслідок ефекту, подібного до дії антидіуретичного гормону, що в поодиноких випадках призводить до гіпонатріємії розведення, що супроводжується летаргією, блюванням, головним болем, дезорієнтацією та неврологічними порушеннями);
■ дуже рідко – гіперпролактинемія (може супроводжуватися галактореєю та гінекомастією), зниження концентрації L-тироксину та підвищення концентрації тиреотропного гормону (зазвичай не супроводжується клінічними проявами), порушення кальцієво-фосфорного обміну в кістковій тканині (зниження концентрації іонів кальцію та 25-ОН- у plasma): osteomalacia, hypercholesterolemia and hypertriglyceridemia.

From the side of the sechostate system:
■ more rarely - interstitial nephritis, nirkov insufficiency, impaired function of nirok (for example, albuminuria, hematuria, oliguria), accelerated sichovipkannya, zatrimka sich, reduced potency.

From the side of the musculoskeletal apparatus:
■ more rarely - arthralgia, myalgia chi sudomi.

From the side of the organs a little:
■ more rarely - damage to the gustatory senses, turbidity of the crystal, conjunctivitis, hearing impairment, noise in the ears, change in the height of the sound.

Other effects:
■ damaged pigmentation of the skins;
■ purpura;
■ acne;
■ promotion of sweating;
■ alopecia.

Overdose

Symptoms
From the side of the nervous system and organs are sensitive:
■ suppression of the functions of the central nervous system;
■ disorientation;
■ drowsiness;
■ arousal;
■ hallucinations;
■ become unobtrusive;
■ coma;
■ zorovі damage (“fog” in front of the eye);
■ dysarthria;
■ nystagmus;
■ ataxia;
■ dyskinesia;
■ hyperreflexia (on the back);
■ hyporeflexia (pіznіshe);
■ sudomi;
■ psychomotor disorders;
■ myoclonus;
■ hypothermia;
■ midriaz.

From the side of the cardiovascular system:
■ tachycardia;
■ decrease in AT, sometimes increase in AT;
■ damage to the internal mucosal conduction with the expansion of the QRS complex;
■ heart denticle.

From the side of the dichal system:
■ prignіchennya dihannya;
■ shabby leg.

From the side of the herbal system:
■ nudota that vomit;
■ zatrimka evakuatsii їzhі zі sluice;
■ decreased motility of the colon.

From the side of the sieve system:
■ zatrymka section;
■ oliguria or anuria;
■ zatrymka rіdini;
■ hyponatremia divorce.

Laboratory indications:
■ leukocytosis and leukopenia;
■ hyponatremia;
■ metabolic acidosis;
■ hyperglycemia and glucosuria;
■ promotion of the m'azovoy fraction of creatine phosphate kinase.

Celebration

Nasampered promyvannya slunka, recognition of an activated vugillya.

Dali - symptomatic support for treatment in intensive care. It is necessary to monitor the functions of the heart, body temperature, corneal reflexes, the function of nirok and sich mihur, correction of electrical disturbances. To support the passage of the dyhal passages - tracheal intubation, piece breathing and / or sour sour.

In case of hypotension or shock: position with lowered head end, plasma pumps, in case of ineffectiveness - internal dopamine or dobutamine; when the rhythm of the heart is disturbed, jubilation is picked up individually; in case of sudomas - the introduction of anti-suicide remedies (for example, diazepam) with protection through the possibility of reducing the respiratory distress.

In case of development of hyponatremia (water intoxication) - exchange of water and total intravenous infusion of 0.9% sodium chloride (may prevent the development of swelling in the brain). It is recommended to carry out hemosorption on carbon sorbents. The next step is to improve the symptoms of overdose again on the 2nd and 3rd day after the cob, which is due to the more frequent use of carbamazepine.

Interaction

Synonyms

Actinerval (Argentina), Apo-Carbamazepine (Canada), Gen-Karpaz (Canada), Zagretol (Croatia), Zeptol (India), Karbadak (India), Carbamazepine-Acri (Russia), Carbamazepine-Teva (Israel), Karbamaz Pharmacy -AT (Bulgaria), Carbamazepin (Denmark), Carbamazepin Nikomed (Norway), Carbamazepin Rivo (Switzerland), Karbapin (Yugoslavia), Karbasan (retard) (Nimechchina), Karbatol (India, Jordan), Mazepin (South) -Karbamaz ( Canada), Stazepin (Poland), Storilat (Cyprus), Tegretol (Switzerland), Timonil (Nimechchina), Finlepsin (Nimechchina), Finlepsin retard (Nimechchina), Epial (Macedonia)

G.M. Barer, E.V. Zoryan