三叉神经痛的诱发电位和动作电位研究及其机制探讨

摘要对２０例三叉神经痛患者减压手术前后及８０名无三叉神经痛的正常人分别进行了三叉神经体感诱发电位（ＴＳＥＰ）检测，并对其中１２例在术中三叉神经减压前后进行了三叉神经动作电位（ＴＣＡＰ）测量，并就其结果的对比性研究，确定ＴＳＥＰ的早期成分Ｐ＿３（或Ｎ＿３）属三叉神经诱发电位，而不是肌电位。认为Ｐ＿３（或Ｎ＿３）是三叉神经根及三叉神经脊束核的突触前和突触后的混合电位。对减压前后ＴＳＥＰ和ＴＣＡＰ的比较，推测原发性三叉神经痛的发病部位在外周，而致痛机制在中枢。

THE STUDY OF THE EVOKED AND ACTION POTENTIALS OF TRIGEMINALNEURALGIA AND THEIR MECHANISM

In this paper we carried out trigeminal somatasensory evoked potential test (TSEP ) for 80 normal persons and 20 trigeminal neuralgia patients preoperatively and postopera-tively, and trigeminal compound action potential (TCAP)in 12 of 20 patients before and after de-compression operation. TCAP was also recorded from the sensory root of the trigeminal nerve duringoperation. It was found that the early component of TSEP,P3(N3)really belonged to the evokedpotentials of trigeminal nerve. It was not the rnuscle potential. We believe that P3(N3 )is mixedpresynaptic and postsynaptic potentials evoked from the trigeminal root and nucleus of trigeminalspine bundle. A comparison between the preoperative and postoperative TSEP and TCAP suggeststhat the origin of primary trigeminal neuralgia is located in the peripheral nerve, and the mechanismof pain may be attributed tO central nervous system.