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სამწვერა ნერვის ნევრალგია | ჯანმრთელობა | vidal.ge

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სამწვერა ნერვის ნევრალგია

თარიღი: 21 იანვარი, 2021

სამწვერა ნერვის ნევრალგია
სამწვერა ნერვი თავის ტვინის მე-5 წყვილი ნერვია, რომელიც უზრუნველყოფს სახის შესაბამისი ნახევრის კანის, ლორწოვანი გარსის (ცხვირი, ტუჩები, ლოყა, კბილები) მგრძნობელობით ინერვაციას (ორგანოთა და ქსოვილთა ნერვებით აღჭურვას), ასევე საღეჭი კუნთების მამოძრავებელ ფუნქციას.

სამწვერა ნერვის ნევრალგიის შესახებ გვესაუბრება „ავერსის კლინიკის“ ექიმი ნევროლოგი, მაია გოდერძიშვილი.

სამწვერა ნერვის ნევრალგია სახის არეში აღმოცენებული ტკივილის ყველაზე ხშირი მიზეზია. იგი ძირითადად გვხვდება საშუალო და ხანდაზმული ასაკის ადამიანებში, უპირატესად კი ქალებში.

სამწვერა ნერვის ნევრალგია ხასიათდება ხანმოკლე ძლიერი ტკივილის შეტევით სამწვერა ნერვის რომელიმე ტოტის ზონაში. ტკივილი ჰგავს ელექტრული დენის დარტყმას, პაციენტს აქვს მტკივნეული გრიმასა, ამიტომაც ამ დაავადებას ,,მტკივნეულ ტიკს’’ ეძახიან. შეტევის ხანგრძლივობა 5 წამიდან - 2 წუთამდე მერყეობს დღის მანძილზე სხვადასხვა სიხშირით. ტკივილს მოჰყვება უსიმპტომო პერიოდები(დღეები, კვირეები, თვეები, იშვიათად რამდენიმე წელიც). რეციდივი 95%- ში გვხვდება იმავე მხარეს. ტკივილის პროვოცირება ხდება ჭამის, საუბრის, სიცილის, პირის ღრუს ჰიგიენის დაცვის დროს.

არსებობს იდიოპათიური(ვერ დგინდება გამომწვევი მიზეზი) და ე.წ. მეორეული, ანუ სამწვერა ნერვის სიმპტომატური ნევრალგიები. მეორეული ნევრალგია გამოწვეულია სხვადასხვა წარმონაქმნების(მათ შორის სისხლძართვოვანი ან სიმსივნური) ნერვზე ზეწოლით ან/და ნერვის დესტრუქციით. ამ შემთხვევებში ხშირად ტკივილი გახანგრძლივებულია. შეტევებს შორის ნერვის ფუნქცია დარღვეულია - ვლინდება როგორც მგრძნობელობითი ფუნქცის მოშლა, ასევე საღეჭი კუნთების დაზიანებაც. ასეთი პაცენტების ასაკი ხშირად ნაკლებია 40 წელზე. 80-90% შემთხვევებში ასეთი ტიპის ნევრალგია გამოწვეულია თავის ტვინში სისხლძარღვის მიერ ნერვის მიჭყლეტით.

ახალგაზრდა ასაკში განვითარებული ნევრალგიის მიზეზებს შორის აგრეთვე არის:
- გაფანტული სკლეროზი
- ნერვის დაზიანება მისივე გარსის ან მეზობელი ქსოვილების სიმსივნეების ზრდის შედეგად
- სხვადასვა ვირუსული (მაგ. ჰერპესული) ან სისტემური დაავადებები

მკურნალობა
სამწვერა ნერვის ნევრალგიის ეფექტური მართვისთვის აუცილებელია ნევრალგიის მიზეზების დადგენა. ნევროლოგის კონსულტაციის საფუძველზე ინიშნება საჭირო ინსრტუმენტული და ლაბორატორიული კვლევები.

მკურნალობის შერჩევა ხდება ნევრალგიის გამომწვევი მიზეზს მიხედვით:
- მედიკამენტოზური - მათ შორის ბოტულინოტოქსინის ინექციები
- ქირურგიული - მიკროვასკულური დეკომპრესია
- რიზოტომია სხვადასხვა მეთოდით, რადიოტალღური ქირურგია და სხვა