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Year : 2014  |  Volume : 9  |  Issue : 8  |  Page : 877

Pathogenesis of trigeminal neuralgia

Chettinad Hospital & Research Institute, Chennai, India

Date of Acceptance14-Apr-2014
Date of Web Publication31-May-2014

Correspondence Address:
M.D. Vengalathur Ganesan Ramesh
Department of Neurosurgery, Chettinad Hospital ?amp; Research Institute, Chettinad Health City, Kelambakkam, Chennai - 603103
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1673-5374.131613

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How to cite this article:
Ramesh VG. Pathogenesis of trigeminal neuralgia. Neural Regen Res 2014;9:877

How to cite this URL:
Ramesh VG. Pathogenesis of trigeminal neuralgia. Neural Regen Res [serial online] 2014 [cited 2019 Oct 19];9:877. Available from: http://www.nrronline.org/text.asp?2014/9/8/877/131613

To the editor,

I read with interest the article, "Differences in individual susceptibility affect the development of trigeminal neuralgia" by Duransoy et al. (2013). The authors have analyzed the possible pathogenesis of trigeminal neuralgia, with illustrative case examples. They have drawn very important conclusions, which may have implications in management of trigeminal neuralgia.

The concept of microvascular compression at the root entry zone of trigeminal neuralgia as the pathogenetic mechanism of trigeminal neuralgia has been contested by various authors (Adams, 1989). This has been shown by the very high incidence of vascular compression at the root entry zone in asymptomatic population (Ramesh and Premkumar, 2009). Though the microvascular compression has been demonstrated in the majority of patients with trigeminal neuralgia and the microvascular decompression surgery results in pain relief, this alone does not explain the pathogenetic mechanism of trigeminal neuralgia. Focal demyelination has been observed in the area of vascular contact by some authors (Love and Coakham, 2001). But the demyelination does not occur in all individuals with the vascular contact. Hence, I also would agree with the authors' view that there must be some individual susceptibility which predisposes to the development of focal demyelination at the root entry zone by vascular contact and causes trigeminal neuralgia and that mere vascular contact at the root entry zone need not result in trigeminal neuralgia. More studies and research are needed in this regard.[4]

  References Top

1.Adams CB (1989) Microvascular compression: an alternative view and hypothesis. J Neurosurg 70:1-12.  Back to cited text no. 1
2.Duransoy YK, Mete M, Akçay E, Selçuki M (2013) Differences in individual susceptibility affect the development of trigeminal neuralgia. Neural Regen Res 8:1337-1342.  Back to cited text no. 2
3.Love S, Coakham HB (2001) Trigeminal neuralgia: pathology and pathogenesis. Brain 124:2347-2360.  Back to cited text no. 3
4.Ramesh VG, Premkumar G (2009) An anatomical study of the neurovascular relationships at the trigeminal root entry zone. J Clin Neurosci 16:934-936.  Back to cited text no. 4

This article has been cited by
1 Computed Tomography in the Diagnosis of Classical Trigeminal Neuralgia
Victor A. Baliazin,Elena V. Baliazina,Daniil P. Aksenov
Journal of Computer Assisted Tomography. 2017; 41(4): 521
[Pubmed] | [DOI]


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