Bowsher D
Pain Research Institute, Walton Hospital, Liverpool, United Kingdom.
Clin Anat. 1997;10(6):409-15. doi: 10.1002/(SICI)1098-2353(1997)10:6<409::AID-CA7>3.0.CO;2-J.
Trigeminal neuralgia (TGN) is a peculiarly painful paroxysmic disorder with an annual incidence of 4.3 per 100,000, which undergoes spontaneous remissions and recurrences. The pain, which is subserved by large not small fibers, can in some cases be triggered from outside the trigeminal territory and by other than mechanical stimuli. There are strong autonomic influences on the pain, and there is cutaneous vasoconstriction in the trigeminal territory in which it occurs. There are also sensory perception deficits for temperature in the affected region and for touch in the whole trigeminal territory. There is now increasing evidence that the majority of cases are caused by vascular compression of the fifth nerve at its point of entry into the pons, for the pain can be relieved (with restoration of the sensory deficit) by surgical decompression. No anatomical abnormalities of the (peripheral) trigeminal nerve have ever been satisfactorily demonstrated. Arguments are examined for the hypothesis that TGN is essentially a disorder of central processing, the term being taken to include the oligodendroglial-sheathed proximal segment of the nerve.
三叉神经痛（TGN）是一种特别疼痛的发作性疾病，年发病率为每10万人中有4.3例，会出现自发缓解和复发。由大纤维而非小纤维传导的疼痛，在某些情况下可由三叉神经区域外的因素以及非机械性刺激引发。疼痛受强烈的自主神经影响，在疼痛发作的三叉神经区域会出现皮肤血管收缩。在受影响区域存在温度感觉障碍，在整个三叉神经区域存在触觉感觉障碍。现在越来越多的证据表明，大多数病例是由第五神经进入脑桥处受到血管压迫所致，因为通过手术减压可缓解疼痛（并恢复感觉障碍）。（外周）三叉神经从未被令人满意地证明存在解剖学异常。本文探讨了关于三叉神经痛本质上是一种中枢处理障碍的假说，这里的中枢处理包括神经的少突胶质细胞包绕的近端节段。
