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1、TrigeminalNeuralgiaandMicrovascularDecompressionLiuZhan,Departmentofneurosurgery，2ndAffiliatedHospital1.DefinitionofTrigeminalNeuralgiaTrigeminalneuralgia (TN,or TGN),alsoknownas prosopalgia, suicidedisease,or Fothergill'sdisease, isa neuropathic disordercharacterizedbyepiso
2、desofintense painintheface,originatingfromthe trigeminalnerve.2.PrevalenceandIncidence2.1150,000peoplearediagnosedwithTNeveryyear（annualoccurrenceis3-5/100,000)2.2Overtheageof50(52-69).2.3Morecommoninwomenthaninmen（F/M，1.74/1).3.EtiologyofTN4.PathologyofTN4.1TNisakindofnon-n
3、ociceptivepain,whichiscausedbycompressionordamagetonervesinsteadofstimulationtoalgesiroreceptor.4.2PeripheralandcentraltheoryofTN:MVC,demyelination,ectopicimpulseintrigeminalnerve,sensoryreflexepilepsy,etc.5.ClinicalcharactersofTN5.1DermatomeofTNTheophthalmicbranch(V1)isresp
4、onsibleforsensationfromthescalp,forehead,uppereyelidandtipofthenose.Themaxillarybranch(V2)sensationcoversthelowereyelid,thesideofthenose,theupperlipandcheek,andtheupperteethandgums.Themandibularbranch(V3)isresponsibleforsensationofthelowerteethandgums,lowerlip,chin,jaw,andpa
5、rtoftheear.Itisalsoresponsibleforsupplyingthemusclesinvolvedwithchewing(mastication),thosemusclesinvolvedwithchewing.5.2MajorclinicalfeaturesofTN5.3DiagnosticcriteriaofTN(FromHIS):5.4DifferentDiagnosisofFacialPainGeneralcausesoforofacialpainGeneralprinciplesinthemedicalmanag
6、ementoffacialpain.TCAs,tricyclicantidepressants.6.TreatmentforTN6.1MedicalTreatment：6.1.1Carbamazapineisthegoldstandardforinitialtreatment.6.3OperationforTN:6.3.1Percutaneousprocedures:Radiofrequencythermal;Glycerolinjection;Microcompression;6.3.2OpenSurgery(MVD):6.3.2.1Theo
7、reticalBasis:6.3.2.2Preoperativeevaluation:3DMRI:3Dtimeofflight(3D-TOF),3Dconstructiveinterferenceinsteady–state(3D-CISS),fastimagingemployingsteady-stateacquisition(FIESTA).In3D-TOF,signalofvenousisisointensive.TheimageofnerveinFIESTAstageissuperiortoitin3D-TOFstage.6.3.2.3
8、Operativetechnique：6.3.3Radiotherapy:TheEnd
