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Pathogenesis of Trigeminal Neuralgia

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Microvascular Decompression Surgery

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Abstract

Facial pain is a common and nonspecific symptom that is associated with known and unknown etiologies. Because the most effective therapeutic interventions address a disorder’s etiopathogenesis, it is important, when possible, to properly classify patients with different etiologies of facial pain. This is particularly true for trigeminal neuralgia (TN), because of the intensity of the pain associated with this disorder. Historically, the term TN has been used to refer to several different conditions. Taken in its most literal and general form, trigeminal neuralgia denotes pain that occurs within the dermatomal distribution of the trigeminal nerve. Many clinicians, however, reserve the term, TN, to signify a more specific disorder, which manifests as attacks of sudden, unilateral, and lancinating facial pain with characteristic triggers (e.g., light touch, cold air). These attacks may result from vascular compression of the trigeminal nerve near its entry into the brainstem (Jannetta 1967; Gardner and Miklos 1959). Vascular compression as the etiopathogenesis of TN, however, occurs in a minority of patients with facial pain. Furthermore, facial pain that does not fit this description completely may also be associated with probable incidental vascular compression.

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Authors and Affiliations

  1. Department of Neurological Surgery, UPMC Presbyterian, Suite B-400, 200 Lothrop Street, Pittsburgh, PA, 15213, USA

    Andrew M. Frederickson BS, MS, Michael S. Gold PhD & Raymond F. Sekula Jr. MD, MBA, FACS

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  1. Andrew M. Frederickson BS, MS
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  2. Michael S. Gold PhD
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  3. Raymond F. Sekula Jr. MD, MBA, FACS
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Editors and Affiliations

  1. Shanghai, China

    Shi-Ting Li

  2. Dept. Neurosurgery, XinHua Hospital, Shanghai, China

    Jun Zhong

  3. UPMC Presbyterian Hospital, Pittsburgh, Pennsylvania, USA

    Raymond F. Sekula, Jr.

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Frederickson, A.M., Gold, M.S., Sekula, R.F. (2016). Pathogenesis of Trigeminal Neuralgia. In: Li, ST., Zhong, J., Sekula, Jr., R. (eds) Microvascular Decompression Surgery. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-7366-9_5

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  • DOI: https://doi.org/10.1007/978-94-017-7366-9_5

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