The aspects of aetiology and peripheral pathogenetic mechanism of trigeminal neuralgia

The article presents the results of a study of 2963 patients with trigeminal neuralgia. Morphological investigation has shown that the peripheral pathogenetic mechanism of neuralgia includes a progressive dystrophy of the peripheral branches of the trigeminal nerve which determines a longlasting continuous afferent impulse transmitting and forming a central pathogenetic mechanism – a pathologic paroxysmal excitation focus in the central nervous system. One of the causes of such process is compression of branches of the trigeminal nerve. In one third of the studied patients, this process was revealed in the narrowed infraorbital canal (causing compression of the 2nd branch of the trigeminal nerve) and in the mandibular canal (resulting in compression of the 3rd branch of the trigeminal nerve). The blood flow velocity in the arteries located in the narrowed canals was less than half the velocity determined in the contralateral arteries located in the unnarrowed canals. The next cause of the progressive dystrophy is immune response taking place in them, during which degranulation of mast cells occurs and histamine is released. The narrowing of the canals and local inflammation are caused by inflammatory disorders in the ear, nose and larynx, and other maxillofacial regions.