Elsevier

Surgical Neurology

Volume 46, Issue 4, October 1996, Pages 358-361
Surgical Neurology

Microvascular decompression for trigeminal neuralgia in patients with multiple sclerosis

https://doi.org/10.1016/S0090-3019(96)00187-5Get rights and content

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  • PJ Jannetta

    Trigeminal neuralgia: treatment by microvascular decompression

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  • Mechanism underlying cranial nerve rhizopathy

    2020, Medical Hypotheses
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    An animal study in support of a link between demyelination and TN-like changes was reported by Burchiel and colleagues [38–40] who observed extra action potentials produced in the V root following iatrogenic demyelination in response to stimulation. Jannetta hypothesized that compression-induced demyelination allowed the spread of ephaptic impulse transmission at these sites [41,42]. It had been believed that damage to the REZ induced parts of the trigeminal ganglion to develop autorhythmicity, which was called as “ignition hypothesis” [22].

  • Deep brain stimulation and multiple sclerosis: Therapeutic applications

    2014, Multiple Sclerosis and Related Disorders
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    It is thought that focal axonal demyelination caused by the compressive lesion allows ephaptic transmission of impulses between physically juxtaposed axons, and that this generates pain sensations, perhaps due to cross-communication between fibres conducting information about light touch and those conducting pain and temperature information (Love and Coakham, 2001). In MS, the demyelination is usually primary rather than compressive in origin, involving either the trigeminal nerve root, nucleus or descending tracts (Resnick et al., 1996) although the mechanism of pain generation is still thought to be the conduction of ectopic nerve impulses between adjacent axons (Love and Coakham, 2001). Other differences between idiopathic trigeminal neuralgia and trigeminal neuralgia in MS (MS-TN) include observations that the latter is more likely to be bilateral in MS sufferers than in the general population (Hooge and Redekop, 1995), more likely to involve the ophthalmic division of the trigeminal nerve (Cordella et al., 2009), and according to some sources, more likely to occur at a younger age (however, this latter point has been disputed) (Hooge and Redekop, 1995).

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