三叉神経痛と顔面痙攣の疫学

Prevalences of Trigeminal Neuralgia and Hemifacial Spasm

Point

・三叉神経痛，顔面痙攣の疫学を知ることは，脳神経外科医にとって重要なことである．

・三叉神経痛の年間発生率は4.3〜28.9人/10万人，有病率は76.8人/10万人で，年齢とともに増加する．女性，右側に多く，原因血管として上小脳動脈が最も多い．

・三叉神経痛に対する神経血管減圧術の長期効果は，80%に痛みの完全消失を認め，合併症は5.2%と熟達者が行うと，安全で高い治療効果が期待できる．

・顔面痙攣の年間発生率は0.78人/10万人，有病率は10人前後/10万人で，年齢とともに増加する．女性，左側に多い．原因血管としては，前下小脳動脈単独が最も多い．

・顔面痙攣に対する神経血管減圧術の長期効果は，87.1%に顔面痙攣の完全消失を認め，合併症は3.0%と三叉神経痛と同様に熟達者が行うと，安全で高い治療効果が期待できる．

　Neurosurgeons must have knowledge about the epidemiology of trigeminal neuralgia and facial spasm. The annual incidence of trigeminal neuralgia is 4.3-28.9 per 100,000 persons, with a prevalence of 76.8 per 100,000 persons, increasing with age. It is more common in women and on the right side, with SCA being the most common causative vessel. The long-term efficacy of MVD for trigeminal neuralgia is 80% with complete resolution of pain and 5.2% with complications, which is safe and highly effective when performed by an expert surgeon.

　Hemifacial spasm has an annual incidence of 0.78/100,000 with a prevalence of approximately 10 per 100,000, increasing with age. It is more common in women and on the left side. AICA alone is the most common causative vessel. The long-term efficacy of MVD for facial spasms is 87.1% with complete resolution of facial spasms and 3.0% with complications. As with trigeminal neuralgia, safe and highly effective treatment can be expected when treated by an expert surgeon.