What causes trigeminal neuralgia and what causes trigeminal neuralgia

Most of them are caused by blood vessels compressing the trigeminal nerve, which can be surgically separated, generally without injury, and the ** rate is very high.

The main cause of trigeminal neuralgia is compression of the blood vessels and nerves. The 12 pairs of cranial nerves in the human body originate from the brain and are distributed directly to different parts of the head and face, and each pair of cranial nerves supports and performs corresponding functions. If the trigeminal nerve root and blood vessels are attached to each other, the pulsation of the blood vessels can cause a "nerve short-circuit".

Trigeminal neuralgia occurs when the excitability of the trigeminal nerve increases.

Trigeminal neuralgia is a kind of reversible throbbing pain of the face, also known as "cramps", which belongs to radicular pain and is more common in middle-aged and elderly people. Those with clear causes are called secondary trigeminal neuralgia, and those with unknown causes are called primary trigeminal neuralgia.

According to clinical practice and research, it has been found that various lesions (changes) in the part of the trigeminal nervous system or adjacent parts can cause trigeminal neuralgia. For secondary trigeminal neuralgia, the most common tumors are intracranial and skull base tumors (mainly tumors near cerebellar pons, trigeminal nerve roots, or semilunar nodes), vascular malformations (aneurysms), thickened arachnoid adhesions, multiple sclerosis, etc. Brain tumors are found in only 1% to 5% of patients with trigeminal neuralgia, with acoustic neuroma being the most common.

There is no satisfactory explanation for the development of primary trigeminal neuralgia, and it is generally believed to be caused by vascular compression; Some pathologists and dentists believe that trigeminal neuralgia may be due to slow tooth loss; Some scholars believe that the onset of trigeminal neuralgia is involved in the central mechanism, and the retrograde activity of the trigeminal nerve may change the electrophysiological activity of the trigeminal nerve.

In addition, trigeminal neuralgia also has various triggers, such as drinking hot and cold water, blowing nose, brushing teeth, washing face, shaving, combing hair, coughing, breezy face, etc.

The ** of trigeminal neuralgia is not well understood, but the details are as follows:

1. Trigeminal nerve root vascular compression: accounting for more than 80%, blood vessels compress the trigeminal nerve, resulting in demyelinating lesions, and microvascular decompression surgery can be performed;

2. Cerebellopontine angle tumors: common acoustic neuroma, trigeminal schwannoma, cholesteatoma, etc.;

3. Other reasons: relatively few.

Once trigeminal neuralgia is suspected, CT and MR examinations should be performed, and microvascular decompression surgery is recommended for those with clear responsibility for vascular compression, and drugs, radiofrequency, and gamma knife may be considered if there is no clear indication for surgery.

Trigeminal neuralgia is generally characterized by paroxysmal, transient, and severe pain, and trigeminal neuralgia is divided into primary trigeminal neuralgia and secondary trigeminal neuralgia. In the case of secondary trigeminal neuralgia, there is generally a clear **, most of which are compressed by tumors and metastases at the base of the skull or cerebellar angle, meningitis, etc., and some are the trigeminal nerve invaded by brainstem infarction and multiple sclerosis.

Trigeminal neuralgia is a common neurological disease that occurs mostly in the elderly, while trigeminal neuralgia includes both primary and secondary categories according to the different types of **. Secondary trigeminal neuralgia refers to a very clear type of trigeminal neuralgia, and its common causes include tumors such as cholesteatoma, trigeminal schwannoma, acoustic neuroma, meningioma, inflammation, cerebrovascular diseases, and skull base malformations.

1. Cerebrovascular micro-disorders:In some patients with trigeminal neuralgia, the cause is cerebrovascular and brain tissue malformations.

2. Intracranial tumor compression:What causes trigeminal neuralgia, intracranial tumor compression can lead to trigeminal neuralgia disease, because of this reason, trigeminal neuralgia disease is often young and middle-aged trigeminal neuralgia patients, and it is often secondary trigeminal neuralgia patients.

3. Demyelination:compression or damage to the sensory root or half-moon node of the trigeminal nerve or periperipherythecular branches of the trigeminal nerve, demyelination; For example, abnormal anatomical structure, vascular malformation, osteosteal inflammation of bone foramen pressure, arteriosclerosis, etc. may induce trigeminal neuralgia.

1**Primary trigeminal neuralgia** is not fully understood, and the peripheral theory is that the lesion is located in the semilunar ganglion to the interpontine part, which is due to compression due to a variety of reasons; The central theory is that trigeminal neuralgia is a sensory seizure in which abnormal discharges may be located in the trigeminal spinal tract nucleus or brainstem.

2. Clinical manifestations.

It is more common in adults and the elderly, with 70% to 80% of patients over 40 years old, and more women than men. Trigeminal neuralgia is often confined to one or two branches of the trigeminal nerve, and is more common in the maxillary and mandibular branches. The seizure is manifested as severe shock-like, pinprick-like, knife-like or tearing pain in the cheeks, upper and lower jaws, and tongue, lasting for a few seconds or 1 2 minutes, with abrupt stopping, and the intermittent period is completely normal.

The corners of the mouth, nasal wings, cheeks, or tongue are sensitive areas that can be induced by light touch, called trigger points or trigger points. In severe cases, reflex twitching of the facial muscles may occur due to pain, and the corners of the mouth may be pulled to the affected side, i.e., painful twitching. The course of the disease is cyclical, with episodes ranging from days, weeks, or months, with periods of remission occurring in the usual person.

As the course of the disease progresses, the number of episodes will gradually increase, the duration of attacks will be prolonged, the intermittent period will be shortened, and even the attacks will be persistent, and they will rarely heal spontaneously. Neurological examination generally has no positive signs, and the main manifestations of patients are afraid to wash their face, brush their teeth, or eat due to fear of pain, poor facial and oral hygiene, haggard complexion, and depressed mood.

3 Check 1Laboratory tests are helpful in clinical diagnosis.

2.Electromyography.

4 Diagnosis of typical primary trigeminal neuralgia is not difficult to diagnose according to the location and nature of the pain, the trigger point of the face, and the absence of positive signs of the nervous system.

What is the cause of trigeminal neuralgia, go to a regular hospital to see: Beijing Liming Trigeminal Neurology Hospital is the best hospital for trigeminal neuralgia, and Wang Yueting is a trigeminal nerve special needs expert. TG—Neuronal repair and regeneration system is the characteristic of the hospital**.

Trigeminal neuralgia is divided into 2 types, one is secondary, the other is primary, and its causes are naturally different.

The trigeminal nerve is the thickest nerve in the face, and its motor part exits the brain at the junction of the pons and pontine arms, joins the mandibular nerve, and passes through the foramen ovale through the skull. The cell body of its sensory part is composed of the trigeminal ganglion located at the petrous tip of the temporal bone.

3. The trigeminal nerve contains two types of fibers: general somatosensory and special visceral movements.

Special visceral motor fibers.

The special visceral motor fibers originate from the motor nucleus of the trigeminal nerve, and its axons form the motor root of the trigeminal nerve, which emerges from the ventral surface of the pontine and the mid-foot of the cerebellum, is located in the anteromedial aspect of the sensory root, and is distributed along the mandibular nerve to the masticatory muscle.

General somatosensory fibers.

The cell body of the general somatosensory fibers is concentrated in the trigeminal nerve node, which is located in front of the trigeminal nerve indentation at the petrous tip of the temporal bone. The trigeminal nerve junction is composed of pseudomonopolar neurons, in which the central processes are clustered into a coarse sensory root of the trigeminal nerve, which enters the back of the head from the ventral surface of the pontine and terminates at the pontine nucleus and the spinal tract nucleus of the trigeminal nerve, and its peripheral processes are distributed in the mucous membranes of the head and face** and the eyes, nose and mouth.

4. It is composed of three large branches composed of peripheral processes that emanate forward from the trigeminal nerve node, and are the ophthalmic nerve, maxillary nerve and mandibular nerve from the inside to the outside.

Ophthalmic nerve (the smallest of the three, containing only general somatosensory fibers, the ophthalmic nerve enters anteriorly into the lateral wall of the cavernous sinus, enters the orbit through the supraorbital fissure, and is distributed in the frontal parietal, upper eyelid, and dorsal nasal **, as well as the eyeball, lacrimal gland, conjunctiva, and part of the nasal mucosa).

1) The lacrimal gland nerve is small, and it goes along the lateral wall of the orbit and the superior border of the lateral rectus muscle to the lacrimal gland and is distributed in the lacrimal gland and upper eyelid. There are several causes of trigeminal neuralgia.