The Pathology of Trigeminal Neuralgia

LIGHT microscopy of the trigeminal ganglion and posterior root obtained at operation from patients with trigeminal neuralgia has yielded controversial and uncertain results in the past; a review of the literature indicates that the opinions ranged from statements that there were no pathologic changes to those that claimed that there were degenerative changes in myelinated fibers, loss of ganglion cells, pronounced hypertrophy of interstitial tissue, or arteriosclerotic changes.¹⁻⁹The electron microscopic characteristics of the trigeminal ganglion and associated root have been well described;¹⁰⁻¹³until the recent report by Beaver and associates,¹⁴no investigation of the ultrastructure of the trigeminal nerve in tic douloureux was available. We fully confirm their finding of pathologic changes in myelinated fibers and note some additional changes. Material and Methods Patients.— Specimens of the ganglion and posterior root were obtained at operation from 13 patients who had trigeminal neuralgia. Of these, six fulfilled