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Microvascular Decompression of the Trigeminal Nerve for Trigeminal Neuralgia

  • Taylor Anne Wilson
  • John Diaz Day
Chapter

Abstract

Facial pain is a relatively common complaint with many different etiologies and anatomical origins. Trigeminal neuralgia (TN), also known as tic douloureux, is one of the most common causes of facial pain. Classically, TN is characterized by excruciating, episodic, lancinating pain in the distribution of one or more branches of cranial nerve V (CNV) that is triggered by a sensory stimulus. The pathophysiology of TN is not completely understood nor agreed upon; however, the prevailing hypothesis is that neurovascular compression of the trigeminal nerve by an artery or vein damages the nerve, resulting in neuronal dysfunction and development of neuropathic pain. Compression may result in damage to the myelin sheath which results in ephaptic transmission of impulses that are perceived as pain. Injured neurons often respond abnormally with heightened sensitivity, increased excitability, spontaneous signaling activity, or aberrant neuronal connectivity. Other neurovascular compression syndromes include hemifacial spasm and glossopharyngeal neuralgia, which involve, respectively, the facial nerve, cranial nerve VII (CNVII), and the glossopharyngeal nerve, cranial nerve IX (CNIX).

Keywords

Trigeminal neuralgia Hemifacial spasm Glossopharyngeal neuralgia Microvascular decompression (MVD) Radiofrequency rhizotomy 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryUniversity of Arkansas for Medical SciencesLittle RockUSA

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