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Diagnosis and Management of Head and Face Pain pp 235–250Cite as

Microvascular Decompression of the Trigeminal Nerve for Trigeminal Neuralgia

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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).

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Authors and Affiliations

  1. Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Taylor Anne Wilson & John Diaz Day

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  1. Taylor Anne Wilson
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Correspondence to John Diaz Day .

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Editors and Affiliations

  1. Department of Otolaryngology-HNS, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    James Y. Suen

  2. Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Erika Petersen

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Wilson, T.A., Day, J.D. (2018). Microvascular Decompression of the Trigeminal Nerve for Trigeminal Neuralgia. In: Suen, J., Petersen, E. (eds) Diagnosis and Management of Head and Face Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-90999-8_19

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