{"id":1386,"date":"2015-09-13T13:55:44","date_gmt":"2015-09-13T13:55:44","guid":{"rendered":"http:\/\/www.harpahreins.com\/blogg\/?p=1386"},"modified":"2018-12-21T11:25:52","modified_gmt":"2018-12-21T11:25:52","slug":"threnndartaugabolga-eda-vangahvot","status":"publish","type":"post","link":"https:\/\/harpahreins.com\/blogg\/2015\/09\/13\/threnndartaugabolga-eda-vangahvot\/","title":{"rendered":"\u00derenndartaugab\u00f3lga e\u00f0a vangahvot"},"content":{"rendered":"

\u00deetta er fyrsta f\u00e6rsla \u00ed f\u00e6rslur\u00f6\u00f0 um \u00ferenndartaugarverk (sem ranglega er kalla\u00f0ur \u00ferenndartaugab\u00f3lga \u00ed fyrirs\u00f6gnum). Hinar eru, \u00ed t\u00edmar\u00f6\u00f0:<\/p>\n

2. Lyfjame\u00f0fer\u00f0 vi\u00f0 \u00ferenndartaugab\u00f3lgu<\/a>;
\n3. \u00derenndartaugin og inngrip gegn \u00ferenndartaugab\u00f3lgu<\/a>
\n4. Skur\u00f0a\u00f0ger\u00f0ir og a\u00f0rar a\u00f0ger\u00f0ir \u00ed e\u00f0a vi\u00f0 \u00ferenndarhno\u00f0a
\n<\/a>5. \u00derenndartaugaverkur\/vangahvot: Saga or\u00f0anna.<\/a><\/p>\n

\u00derenndartaugarverkur (sem einnig er kalla\u00f0ur vangahvot \u00e1 \u00edslensku, Trigeminal neuralgia er algengasta sj\u00fakd\u00f3msheiti\u00f0 \u00e1 ensku) er vi\u00f0varandi (kr\u00f3n\u00edskur) s\u00e1rsauki \u00ed 5. andlitstauginni, svokalla\u00f0ri \u00ferenndartaug\/\u00fer\u00edburataug.1<\/sup> Nafni\u00f0 er dregi\u00f0 af \u00fev\u00ed a\u00f0 \u00feessi taug greinist \u00ed \u00ferennt \u00ed hvorum helmingi andlitsins, s.s. sj\u00e1 m\u00e1 \u00e1 myndinni:<\/p>\n

\"\u00derenndartaug\"<\/a><\/p>\n

\u00derenndartaugin (nervus trigeminus) er skyntaug sem tengist heilanum en liggur um andliti\u00f0. Efsta greinin, augntaug (nervus ophthalmicus), stj\u00f3rnar skynjun \u00ed h\u00f6fu\u00f0le\u00f0ri, enni og framhluta h\u00f6fu\u00f0s. Mi\u00f0greinin, kinnkj\u00e1lkataug (nervus maxillaris), stj\u00f3rnar skynjun \u00ed kinn, efri kj\u00e1lka, efri v\u00f6r, efri tanngar\u00f0i og efri g\u00f3mi, \u00e1samt h\u00e1lfu nefinu. Ne\u00f0sta greinin, kj\u00e1lkataug (nervus mandibularis) stj\u00f3rnar skynjun \u00ed ne\u00f0ri kj\u00e1lka, ne\u00f0ri tanngar\u00f0i, ne\u00f0ri g\u00f3mi og ne\u00f0ri v\u00f6r.1<\/sup><\/p>\n

 <\/p>\n

\"\"<\/a><\/p>\n

 <\/p>\n

D\u00e6miger\u00f0ur\/klass\u00edskur \u00ferenndartaugarverkur<\/strong>\u00a0(oft skammstafa\u00f0ur TN1 \u00e1 ensku) veldur ofbo\u00f0slegum s\u00e1rsaukastingjum \u00ed andlitinu, sem oft minna \u00e1 raflost e\u00f0a bruna. Stingirnir geta vara\u00f0 fr\u00e1 nokkrum sek\u00fandum upp \u00ed tv\u00e6r m\u00edn\u00fatur og \u00feeir geta komi\u00f0 hver \u00e1 f\u00e6tur \u00f6\u00f0rum \u00ed allt a\u00f0 tv\u00e6r klukkustundir samfleytt. Mislangt hl\u00e9 gefst milli s\u00e1rsaukakastanna.1<\/sup> S\u00e1rsaukinn getur veri\u00f0 \u00fea\u00f0 g\u00edfurlegur a\u00f0 \u00feessi ger\u00f0 \u00ferenndartaugarverks ku hafa veri\u00f0 k\u00f6llu\u00f0 \u201esj\u00e1lfsv\u00edgssj\u00fakd\u00f3murinn\u201c. 2<\/sup><\/p>\n

Tal, tygging, tannburstun, rakstur e\u00f0a kaldur vindur \u00ed andlit geta \u00fatleyst verkjakast. \u00de\u00f3 a\u00f0 hvert kast vari a\u00f0eins \u00ed sek\u00fandur getur verkurinn endurteki\u00f0 sig me\u00f0 svo stuttu millibili a\u00f0 k\u00f6stin renni saman \u00ed eitt. Eftir m\u00f6rg k\u00f6st getur sj\u00faklingur upplifa\u00f0 vi\u00f0varandi andlitsverk.3<\/sup><\/p>\n

N\u00e1nari l\u00fdsingu \u00e1 s\u00e1rsaukak\u00f6stum d\u00e6miger\u00f0s \u00ferenndartaugarverks m\u00e1 finna \u00ed tveimur stuttum \u00edslenskum greinum sem tengjast umfj\u00f6llun um vefjagigt. 4,5<\/sup><\/p>\n

Yfirleitt er d\u00e6miger\u00f0ur \u00ferenndartaugarverkur talinn stafa af ska\u00f0a \u00e1 m\u00fdli\/taugasl\u00ed\u00f0ri utan um taugina. Oftast er s\u00e1 ska\u00f0i talinn stafa af \u00e6\u00f0 sem \u00fer\u00fdsti st\u00f6\u00f0ugt \u00e1 taugina.6<\/sup> \u00cd undantekningartilvikum m\u00e1 rekja d\u00e6miger\u00f0an \u00ferenndartaugarverk til \u00e6xlis.1<\/sup><\/p>\n

 <\/p>\n

\u00derenndartaugarverkur 2<\/strong> (oft skammstafa\u00f0ur TN2 \u00e1 ensku, stundum kalla\u00f0ur \u00f3d\u00e6miger\u00f0ur \u00ferenndartaugarverkur og Atypical trigeminal neuralgia skammstaf\u00f0 ATN) veldur sleitulausum verk, \u00fe.e. \u00e1n nokkurs hl\u00e9s, af svipu\u00f0u t\u00e6i og l\u00fdst var a\u00f0 ofan en ekki eins ofbo\u00f0slegum og verkjak\u00f6stin sem einkenna klass\u00edskan \u00ferenndartaugarverk.1<\/sup> Sumir m\u00e6la gegn \u00fev\u00ed a\u00f0 nota heiti\u00f0 \u00f3d\u00e6miger\u00f0an \u00ferenndartaugarverk me\u00f0 \u00feeim r\u00f6kum a\u00f0 s\u00fa sj\u00fakd\u00f3msgreining s\u00e9 gjarna notu\u00f0 sem ruslakistugreining fyrir alls konar andlitsverki sem hafa ekkert me\u00f0 \u00ferenndartaugina a\u00f0 gera.6<\/sup><\/p>\n

Yfirleitt ver\u00f0ur \u00ferenndartaugarverks vart \u00f6\u00f0rum megin \u00ed andlitinu en \u00fe\u00f3 eru sjaldg\u00e6f d\u00e6mi \u00feess a\u00f0 f\u00f3lk \u00fej\u00e1ist af sj\u00fakd\u00f3mnum beggja vegna. Sl\u00edkt g\u00e6ti veri\u00f0 v\u00edsbending um heila- og m\u00e6nusigg.3<\/sup> Einnig eru d\u00e6mi \u00feess a\u00f0 f\u00f3lk s\u00e9 haldi\u00f0 hvoru tveggju d\u00e6miger\u00f0um \u00ferenndartaugarverk og \u00ferenndartaugarverk 2 \u00ed senn.1<\/sup><\/p>\n

 <\/p>\n

\u00c1 s\u00ed\u00f0ari \u00e1rum hafa menn vilja\u00f0 flokka \u00ferenndartaugarverk \u00ed fleiri undirflokka og er \u00fe\u00e1 helst nefnt, auk TN1 og TN2:<\/p>\n

Afleiddur \u00ferenndartaugarverkur<\/strong>\u00a0(Secondary Trigeminal Neuralgia, skst. STN) l\u00fdsir s\u00e9r alveg eins og hinar tegundirnar en m\u00e1 tengja vi\u00f0 a\u00f0 sj\u00faklingurinn s\u00e9 haldinn heila- og m\u00e6nusiggi (multiple sclerosis).6<\/sup><\/p>\n

Einnig hefur veri\u00f0 bent \u00e1 a\u00f0 \u00ferenndartaugarverkur geti veri\u00f0 fylgifiskur vefjagigtar en \u00f3lj\u00f3st er hvernig \u00feeim tengslum \u00e6tti a\u00f0 vera h\u00e1tta\u00f0.4, 5<\/sup><\/p>\n

\u00derenndartaugarverkur eftir \u00e1bl\u00e1sturss\u00f3tt\/ristil<\/strong>\u00a0(Post-Herpetic neuralgia, skst. PHN) er eftirk\u00f6st eftir ristil (herpes zoster) vi\u00f0 \u00ferenndartaugina.6<\/sup><\/p>\n

\u00derenndartaugarr\u00f6skun sem stafar af starfr\u00e6nni truflun<\/strong> (Trigeminal Neuropathic Pain, skst. TNP) er \u00feegar rekja m\u00e1 kvillann til einhvers konar \u00f3viljandi ska\u00f0a \u00e1 tauginni. S\u00e1 ska\u00f0i getur veri\u00f0 \u00e1verki \u00e1 andliti, af munnskur\u00f0l\u00e6kningum e\u00f0a skur\u00f0a\u00f0ger\u00f0um sem tengjast h\u00e1ls-nef og eyrnal\u00e6kningum, ska\u00f0i \u00e1 tauginni vegna skur\u00f0a\u00f0ger\u00f0a \u00ed aftari k\u00fapugr\u00f3f (fossa cranii posterior) e\u00f0a annars sta\u00f0ar ne\u00f0st \u00ed h\u00f6fu\u00f0k\u00fapu, af heilabl\u00f3\u00f0falli o.fl. S\u00e1rsaukinn er sag\u00f0ur draga \u00far sj\u00faklingnum m\u00e1tt, vera brennandi e\u00f0a eins og bora\u00f0 s\u00e9 \u00ed auma sv\u00e6\u00f0i\u00f0. Verkurinn er oftast sleitulaus vegna \u00feess a\u00f0 sk\u00f6\u00f0u\u00f0 taugin sendir st\u00f6\u00f0ugt verkjabo\u00f0 til heilans. Ska\u00f0inn getur l\u00edka gert taugina ofurn\u00e6ma fyrir \u00e1reiti svo svipu\u00f0 s\u00e1rsaukak\u00f6st geta fylgt \u00feessari ger\u00f0 \u00ferenndartaugarverk og d\u00e6miger\u00f0um \u00ferenndartaugarverk, s\u00e1rsaukinn blossar \u00fe\u00e1 venjulega upp \u00e1 sama sta\u00f0 og \u00e1reiti\u00f0 ver\u00f0ur. Tilfinningaleysi og n\u00e1ladofi benda einnig til skadda\u00f0rar taugar.6<\/sup><\/p>\n

\u00deessi ger\u00f0 af \u00ferenndartaugarr\u00f6skunar er hins vegar s\u00f6g\u00f0 heita secondary trigeminal neuralgia [sj\u00e1 um afleidda \u00ferenndartaugab\u00f3lgu h\u00e9r a\u00f0 ofan] \u00ed n\u00fdlegri \u00edslenskri kennslub\u00f3k handa l\u00e6kna- e\u00f0a lyfjafr\u00e6\u00f0inemum. \u00dear segir einnig a\u00f0 s\u00e9 \u201evangahvot ors\u00f6ku\u00f0 af ytri ska\u00f0a \u00e1 \u00ferenndartauginni […] geta veri\u00f0 teikn um skynbrottfall \u00e1 sv\u00e6\u00f0i hennar og jafnvel m\u00e1ttleysi og r\u00fdrnun tyggingarv\u00f6\u00f0va\u201c.3<\/sup><\/p>\n

\u00derenndartaugarverkur eftir a\u00f0ger\u00f0 \u00e1 mi\u00f0taugakerfi<\/strong> (Trigeminal Deafferentation Pain, skst. TDP) eru verkir \u00ed andliti sem tengjast tilfinningaleysi \u00ed \u00ferenndartaug eftir skur\u00f0a\u00f0ger\u00f0 vi\u00f0 \u00ferenndartaugarverk. \u00deessar skur\u00f0a\u00f0ger\u00f0ir mi\u00f0a allar a\u00f0 \u00fev\u00ed a\u00f0 ska\u00f0a \u00ferenndartaugina til l\u00e6kninga og m\u00e1 a\u00f0allega nefna taugar\u00farn\u00e1m, \u00fe.e. brottn\u00e1m hluta taugar (neurectomy), ey\u00f0ileggingu taugahno\u00f0a (gangliolysis), \u00feverskur\u00f0 taugar\u00f3tar (rhizotomy), \u00feverskur\u00f0 taugabrautar utan m\u00e6nukylfu (nucleotomy) og brautarskur\u00f0, \u00fe.e. \u00feverskur\u00f0 taugabrautar \u00ed m\u00e6nukylfu (tractotomy). \u00der\u00e1tt fyrir a\u00f0 allar \u00feessar a\u00f0ger\u00f0ir mi\u00f0i a\u00f0 \u00fev\u00ed a\u00f0 ey\u00f0a tilfinningu\/skynjun \u00ed \u00ferenndartauginni getur fylgt \u00ed kj\u00f6lfari\u00f0 st\u00f6\u00f0ugur s\u00e1rsauki \u00ed dofnum andlitshlutum, t.d. brennandi, ertandi e\u00f0a n\u00edstandi s\u00e1rsauki.6<\/sup><\/p>\n

Loks m\u00e6tti nefna a\u00f0 til er flokkurinn \u00d3d\u00e6miger\u00f0ir andlitsverkir (Atypical Facial Pain (AFP)), sem eru verkir \u00ed andliti \u00e1n \u00feess a\u00f0 ors\u00f6k finnist fyrir \u00feeim. Eitthva\u00f0 af \u00fev\u00ed sem fellur \u00ed \u00fe\u00e1 ruslakistu g\u00e6ti veri\u00f0 birtingarmynd \u00ferenndartaugarverks.<\/p>\n

 <\/p>\n

Algengi<\/strong><\/p>\n

T\u00f6lum um algengi \u00ferenndartaugarverks ber ekki alveg saman \u00ed heimildum en lj\u00f3st er a\u00f0 \u00feetta er sjaldg\u00e6fur sj\u00fakd\u00f3mur. Oftast er tala\u00f0 um a\u00f0 u.\u00fe.b. 0,005-0,01% f\u00f3lks \u00fej\u00e1ist af \u00ferenndartaugarverk en \u00f3v\u00edst hvort \u00fe\u00e1 er eing\u00f6ngu veri\u00f0 a\u00f0 tala um d\u00e6miger\u00f0sa \u00ferenndartaugarverk e\u00f0a \u00f6ll afbrig\u00f0i hans.1,2,6,7<\/sup> H\u00e6sta tala sem \u00e9g fann kom fram \u00ed breskri ranns\u00f3kn sem s\u00fdndi 0,026% algengi \u00ferenndartaugarverks me\u00f0al sj\u00faklinga \u00e1 breskum heilsug\u00e6slust\u00f6\u00f0vum.8<\/sup> En bent hefur \u00e1 a\u00f0 \u00ed \u00feeirri ranns\u00f3kn hafi e.t.v. \u00f3vart veri\u00f0 taldir me\u00f0 sj\u00faklingar me\u00f0 andlitsverki af \u00f6\u00f0rum toga.9<\/sup><\/p>\n

Heimildum ber saman um a\u00f0 \u00ferenndartaugarverkur komi yfirleitt ekki fram fyrr en eftir fimmtugt og a\u00f0 h\u00fan s\u00e9 algengari me\u00f0al kvenna en karla. \u00c9g leyfi m\u00e9r a\u00f0 setja fram \u00fe\u00e1 fullyr\u00f0ingu a\u00f0 \u00feess vegna s\u00e9 \u00feetta sennilega vangreindur sj\u00fakd\u00f3mur og algengari en haldi\u00f0 er fram \u00ed heimildum sem v\u00edsa\u00f0 var \u00ed h\u00e9r a\u00f0 ofan \u00fev\u00ed af reynslus\u00f6gum kvenna af heilbrig\u00f0iskerfinu, \u00ed Facebook h\u00f3pi sem \u00e9g tilheyri, m\u00e1 r\u00e1\u00f0a a\u00f0 \u201ekona me\u00f0 verk\u201c s\u00e9 oftar en ekki hunsu\u00f0 af l\u00e6knum, einkum \u00e1 heilsug\u00e6slust\u00f6\u00f0vum.<\/p>\n

 <\/p>\n

Heimildir<\/strong><\/p>\n

1\u00a0Trigeminal Neuralgia Fact Sheet<\/a><\/em>. (2013). National Institute of Neurological Disorders and Stroke, NIH b\u00e6klingur nr. 13-5116. S\u00ed\u00f0ast uppf\u00e6r\u00f0ur \u00e1 vef 27. j\u00fal\u00ed 2015. Sko\u00f0a\u00f0 4. sept. 2015.<\/p>\n

2 Trigeminal neuralgia<\/a>. Wikipedia<\/em>. Sko\u00f0a\u00f0 4. september 2015.<\/p>\n

3 Ari J. J\u00f3hannesson o.fl. (2015).\u00a0Handb\u00f3k \u00ed lyfl\u00e6knisfr\u00e6\u00f0i<\/em>. 4. \u00fatg., s. 363-4. Reykjav\u00edk:H\u00e1sk\u00f3la\u00fatg\u00e1fan og Landsp\u00edtali H\u00e1sk\u00f3lasj\u00fakrah\u00fas.<\/p>\n

4 Sigr\u00fan Baldursd\u00f3ttir. (2010). Andlits- og kj\u00e1lkaverkir (Orofacial Pains) – II. Hluti Vangahvot -Trigeminal neuralgia Gigtin 21<\/em>(1), s. 15-16. Reykjav\u00edk:Gigtarf\u00e9lag \u00cdslands. A\u00f0gengilegt \u00e1 vef<\/a>.<\/p>\n

5 Sigr\u00fan Baldursd\u00f3ttir. (e.d.) Trigeminal neuralgia. Andlits- og kj\u00e1lkaverkir Andlits- og kj\u00e1lkaverkir (Orofacial Pains) – II. Hluti<\/a>. Vefjagigt. Fr\u00e6\u00f0sluvefur um vefjagigt og s\u00ed\u00fereytu<\/em>. Sko\u00f0a\u00f0 9. sept.2015.<\/p>\n

6 Classifications of Neuropathic Facial Pain<\/a>. (e.d.) TNA \u2013 The Facial Pain Association<\/em>. Sko\u00f0a\u00f0 9. sept. 2015.<\/p>\n

7 \u00a0Trigeminal Neuralgia<\/a>. (2014).\u00a0NORD:National Organization for Rare Disorders<\/em>. Sko\u00f0a\u00f0 9. sept. 2015.<\/p>\n

8 Kenny, Tim og Colin Tidy. Who gets trigeminal neuralgia (TN)?<\/a> (2014).\u00a0Patient<\/em>. Sko\u00f0a\u00f0 9. sept. 2015.<\/p>\n

9 Hall, Gillian C. o.fl. (2006). Epidemiology and treatment of neuropathic pain: The UK primary care perspective. Pain 122<\/em>(1-2), s. 156-162. A\u00f0gengilegt \u00e1 vef<\/a>. Sko\u00f0a\u00f0 8. sept. 2015.<\/p>\n

10 Zakrzewska, Joanna M. (2010). Facial Pain. \u00cd C. Stannard, E. Kalso og J. Ballantyne (ritstj\u00f3rar), Evidence-Based Chronic Pain Management<\/em>, bls.134-150. Oxford:Wiley-Blackwell.<\/p>\n","protected":false},"excerpt":{"rendered":"

\u00deetta er fyrsta f\u00e6rsla \u00ed f\u00e6rslur\u00f6\u00f0 um \u00ferenndartaugarverk (sem ranglega er kalla\u00f0ur \u00ferenndartaugab\u00f3lga \u00ed fyrirs\u00f6gnum). Hinar eru, \u00ed t\u00edmar\u00f6\u00f0: 2. Lyfjame\u00f0fer\u00f0 vi\u00f0 \u00ferenndartaugab\u00f3lgu; 3. \u00derenndartaugin og inngrip gegn \u00ferenndartaugab\u00f3lgu 4. Skur\u00f0a\u00f0ger\u00f0ir og a\u00f0rar a\u00f0ger\u00f0ir \u00ed …<\/span> Read More …<\/span><\/a><\/span><\/p>\n","protected":false},"author":1,"featured_media":1387,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[113],"tags":[116,121,115,122],"class_list":["post-1386","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-threnndartaugabolga","tag-vangahvot","tag-threnndartaug","tag-threnndartaugabolga","tag-thriburataug"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2015\/09\/trenndartaug_skyringarmynd.jpg?fit=717%2C542&ssl=1","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/1386","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/comments?post=1386"}],"version-history":[{"count":15,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/1386\/revisions"}],"predecessor-version":[{"id":1633,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/1386\/revisions\/1633"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/media\/1387"}],"wp:attachment":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/media?parent=1386"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/categories?post=1386"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/tags?post=1386"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}