Trigeminal neuralgia (TN), characterized by brief, recurrent paroxysms of lancinating pain in the distribution of 1 or more branches of the trigeminal nerve (fifth cranial nerve [CN V]), is one of the most common, severe, and likely overdiagnosed forms of neuropathic pain. For decades, neurosurgical dogma has stressed the role of neurovascular compression (NVC) of the centrally myelinated portion of the cisternal segment of CN V in disease pathogenesis, reinforcing the use of microvascular decompression for treatment.
Panchagnula S, Sularz AK, Kahle KT. Familial Trigeminal Neuralgia Cases Implicate Genetic Factors in Disease Pathogenesis. JAMA Neurol. 2019;76(1):9–10. doi:10.1001/jamaneurol.2018.3322
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