sibneiroСибнейроSibneuro3033-649X3033-6805Bervitskiy Anatoliy Vladimirovich10.64265/3033-649X-2026.2.2.41-51sibneiro-83Research ArticleОригинальные исследованияOriginal researchОпыт применения интраоперационной микронейрографии у пациентов с классической невралгией тройничного нерваIntraoperative microneurography in patients with classic trigeminal neuralgiahttps://orcid.org/0000-0002-6253-9883ЛехновЕ. А.LekhnovE. A.

Лехнов Евгений Анатольевич – кандидат медицинских наук; ассистент кафедры нейрохирургии

Красный просп., 52, Новосибирск, 630091

ул. Немировича-Данченко, 132/1, г. Новосибирск, 630087

Evgeniy A. Lekhnov – Cand. Sci. (Med.); Teaching Assistant at the Department of Neurosurgery

Krasny ave., 52, Novosibirsk, 630091

Nemirovicha-Danchenko str., 132/1, Novosibirsk, 630087

ekchnov@gmail.comhttps://orcid.org/0009-0003-3739-8438АлзиралхусейниА. Ф.AlziralkhuseyniA. F.

Алзиралхусейни Абедалла Ф. – аспирант кафедры нейрохирургии

Красный просп., 52, Новосибирск, 630091

Abedallah F. Alziralkhuseyni – Post-graduate Researcher at the Department of Neurosurgery

Krasny ave., 52, Novosibirsk, 630091

abedallahalhussini@gmail.comhttps://orcid.org/0000-0002-7946-8639СлавинК. В.SlavinK. V.

Славин Константин Владимирович – профессор, за ведующий кафедрой стереотаксической и функциональной нейрохирургии

Вест Харрингтон-стрит, 1200, Чикаго, Иллинойс, 60607

Konstantin V. Slavin – Professor, Head of the Department of Stereotaxic and Functiounal Neurosurgery

West Harrison str., 1200, Chicago, Illinois, 60607

kslavin@uic.eduНовосибирский государственный медицинский университет Минздрава России; Федеральный центр нейрохирургии Минздрава РоссииNovosibirsk State Medical University; Federal Neurosurgical CenterНовосибирский государственный медицинский университет Минздрава РоссииNovosibirsk State Medical UniversityУниверситет ИллинойсаUniversity of Illinois Chicago202627062026224151Copyright © Лехнов Е.А., Алзиралхусейни А.Ф., Славин К.В., 20262026Лехнов Е.А., Алзиралхусейни А.Ф., Славин К.В.Lekhnov E.A., Alziralkhuseyni A.F., Slavin K.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibneurojournal.com/jour/article/view/83

Цель исследования. Представить первые результаты применения интраоперационной микронейрографии корешка тройничного нерва у пациентов с классической невралгией тройничного нерва и оценить взаимосвязь между регистрируемой электрической активностью и регрессом или сохранением боли после микроваскулярной декомпрессии.Материалы и методы. В  исследование включено 13  пациентов с  классической невралгией тройничного нерва, которым выполнена микроваскулярная декомпрессия (МВД), и 4  пациента с  опухолями задней черепной ямки (контрольная группа). Пациенты распределены на три группы: группа 1 – МВД с тактильной стимуляцией (n = 9); группа 2 – МВД без стимуляции (n = 4); контрольная группа (группа 3) – с тактильной стимуляцией (n = 4). Регистрация электрической активности корешка нерва проводилась до и после декомпрессии. Оценка болевого синдрома выполнялась с использованием визуальной аналоговой шкалы и  шкалы Неврологического института Барроу (BNI, Barrow Neurological Institute).Результаты. У  всех пациентов группы  1 до  операции глубокая тактильная стимуляция вызывала электрическую активность корешка тройничного нерва, тогда  как поверхностная стимуляция не  сопровождалась регистрируемой активностью. После МВД в 67 % случаев (6  из  9) отмечено значительное снижение электрической активности, что  коррелировало с  регрессом боли. У  трех пациентов с сохранявшейся болью (группа 1) электрическая активность регистрировалась и после операции. В группе 2 спонтанной эктопической активности не выявлено. В контрольной группе характерной для классической невралгии тройничного нерва электрической активности не обнаружено. Отношение амплитуды сигнала к фону у пациентов с персистирующей болью после операции было статистически значимо выше 1 по сравнению с группой регресса боли (p = 0,003).Заключение. Интраоперационная микронейрография позволяет выявлять патологическую электрическую активность корешка тройничного нерва у  пациентов с  классической невралгией тройничного нерва, которая коррелирует с  наличием болевого синдрома и  его  регрессом после оперативного вмешательства. Предложенный показатель отношения амплитуды электрической активности к фону может рассматриваться как потенциальный критерий эффективности декомпрессии, однако требует дальнейшего изучения на расширенной выборке.

The aim. To present the fi rst results of intraoperative microneurography of the trigeminal root in patients with classic trigeminal neuralgia and  to  assess the  relationship between recorded electrical activity and pain regression or persistence after microvascular decompression.Materials and methods. The study included 13 patients with classic trigeminal neuralgia who underwent microvascular decompression (MVD) and 4 patients with posterior cranial fossa tumors (control group). Patients were divided into three groups: Group 1 – MVD with tactile stimulation (n = 9); Group 2 – MVD without stimulation (n = 4); Group 3 – control group with tactile stimulation (n = 4). Electrical activity of the nerve root was recorded before and after decompression. Pain assessment was performed using the Visual Analog Scale and the BNI scale.Results. In all patients of Group 1, deep tactile stimulation evoked electrical activity of the trigeminal root before surgery, whereas superfi cial stimulation was not accompanied by recordable activity. After MVD, a signifi cant reduction in electrical activity was observed in 67 % of cases (6 out of 9), which correlated with pain regression. In  three patients with persistent pain (Group  1), electrical activity was  also recorded after surgery. In Group 2, no spontaneous ectopic activity was detected. In the control group, no electrical activity characteristic of classic trigeminal neuralgia was found. The signal-to-background amplitude ratio in patients with persistent pain after surgery was signifi cantly greater than 1 compared to the pain regression group (p = 0.003).Conclusion. Intraoperative microneurography allows the  detection of  pathological electrical activity of the trigeminal root in patients with classic trigeminal neuralgia, which correlates with the presence of pain and its regression after surgical intervention. The proposed parameter – the ratio of electrical activity amplitude to  background – may  be considered a  potential criterion for  the  eff ectiveness of decompression, but requires further study in an expanded cohort.

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The authors declare that there are no conflicts of interest present.