Trigeminal neuralgia is defined by its clinical characteristics of paroxysmal unilateral facial pain in a well-defined territory. Distribution of the pain may be in one or several of the cutaneous and/or mucous territories of the three divisions with V2 pain being the most frequent territory followed by V3 and V1. Factors determining the distribution of pain have not yet been systematically investigated. It is now well recognized that vascular compression factor is a predominant aetiology of classical trigeminal neuralgia. In this study we aimed to find whether there is a relation between the location of the vascular compression and the peripheral distribution of the pain. Patients with classical trigeminal neuralgia in whom microvascular decompression was performed were included. Data recorded pertained to the nature of the conflict, its degree and, most importantly, location around the root: supero-median, supero-lateral or inferior. Equally, clinical data for the distribution of pain were recorded. Most of the patients 318 (89.3%) had the compression coming from above, i.e. 220 (61.7%) had compression from a supero-medial direction and 98 (27.5%) from a supero-lateral direction; inferior compression was present in 38 patients (10.7%). Distribution of the pain was significantly different according to the location of the conflict (P = 0.0005, Fisher Exact test). Odds ratios were computed for each location of compression and painful territory involved. According to the overall distribution of pain, patients with supero-medial compression had an odds ratio of 2.7 [95% confidence interval (CI) 1.66-4.41] of manifesting with V1 pain. Conversely V3 pain was less likely to occur with supero-median compression than the other types of pain (odds ratio 0.53, 95% CI 0.34-0.83). Inferior compression on the other hand was more likely to manifest with V3 pain with an odds ratio of 2.56 (95% CI 1.21-5.45). Overall V2 pain had an odds ratio close to 1 regardless of the type of compression. These findings suggest an association between the location of the neurovascular conflict with its resulting insult and the distribution of pain supporting a somatotopic view of the organization of the trigeminal root and a role of the conflict in the clinical manifestation of trigeminal neuralgia.

中文翻译：

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经典三叉神经痛疼痛的地形图：对体位组织的见解。

三叉神经痛由其在明确区域内的阵发性单侧面部疼痛的临床特征定义。疼痛的分布可能在三个分区的一个或几个皮肤和/或粘液区域中，其中V2疼痛是最常见的区域，其次是V3和V1。尚未确定确定疼痛分布的因素。现在众所周知，血管压缩因子是经典三叉神经痛的主要病因。在这项研究中，我们旨在发现血管受压的位置与疼痛的周围分布之间是否存在关系。包括进行了微血管减压的经典三叉神经痛患者。记录的数据与冲突的性质有关，它的程度以及最重要的是围绕根的位置：上中上，上外或下。同样，记录疼痛分布的临床数据。大多数患者318（89.3％）的压力来自上方，即220例（61.7％）的压力来自上-内侧方向，而98例（27.5％）的压力来自上-外侧方向。38例患者存在下压迫感（10.7％）。根据冲突的位置，疼痛的分布有显着差异（P = 0.0005，Fisher Exact检验）。计算每个受压部位和疼痛区域的赔率。根据疼痛的总体分布，超中度压迫患者表现为V1疼痛的比值比为2.7 [95％置信区间（CI）1.66-4.41]。相反，与其他类型的疼痛相比，超中位压迫发生V3疼痛的可能性更小（优势比为0.53，95％CI为0.34-0.83）。另一方面，V3疼痛更容易表现出较弱的压迫，优势比为2.56（95％CI 1.21-5.45）。不管压缩的类型如何，总体V2疼痛的优势比接近1。这些发现表明，神经血管冲突的位置及其导致的损害与疼痛的分布之间存在关联，该疼痛的分布支持了对三叉神经根组织的体视学观点以及该冲突在三叉神经痛的临床表现中的作用。56（95％CI 1.21-5.45）。不管压缩的类型如何，总体V2疼痛的优势比接近1。这些发现表明，神经血管冲突的位置及其导致的损害与疼痛的分布之间存在关联，该疼痛的分布支持了对三叉神经根组织的体视学观点以及该冲突在三叉神经痛的临床表现中的作用。56（95％CI 1.21-5.45）。不管压缩的类型如何，总体V2疼痛的优势比接近1。这些发现表明，神经血管冲突的位置及其导致的损害与疼痛的分布之间存在关联，该疼痛的分布支持了对三叉神经根组织的体视学观点以及该冲突在三叉神经痛的临床表现中的作用。