Features of the Trigeminal Nerve in Inflammatory Diseases of the Maxillofacial Region
Keywords:
trigeminal neuralgia, trigeminal nerve root, neurovascular conflict, demyelination, microvascular decompression, maxillofacial regionAbstract
Classical trigeminal neuralgia (TN) is a severe paroxysmal pain syndrome that exhausts patients mentally and physically and significantly limits their working and personal lives. The aim of this article is to analyse current concepts of the pathogenesis, clinical features, diagnosis and treatment of classical TN, with emphasis on the neurovascular conflict and the morphofunctional changes of the trigeminal nerve root. An analytical review of foreign and Russian-language publications from 2000–2010 was carried out using comparative analysis, generalisation and systematisation. The analysis showed that the key pathogenetic mechanism is a neurovascular conflict in which an arterial loop crossing the nerve root causes prolonged intermittent compression and focal demyelination, whereas simple contact of a vessel with the root, frequently found in asymptomatic individuals, does not. The anatomical variant of the conflict influences the clinical picture, and neuroimaging is necessary in all patients to exclude symptomatic forms. Conservative treatment should target the trigger zones, remyelination and central sensitisation, while microvascular decompression is indicated when drug therapy fails.
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