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Ipsilateral trigeminal sensory responses to cortical stimulation by subdural electrodes
Neurology
|December 1, 1985
Summary
Electrical stimulation of the brain during epilepsy surgery revealed unexpected facial sensations. These findings suggest trigeminal nerve fibers may accompany blood vessels in the human brain, a pathway previously unconfirmed in humans.
Area of Science:
- Neurosurgery
- Neurophysiology
- Epileptology
Background:
- Medically intractable epilepsy often requires surgical evaluation.
- Chronic subdural electrodes are used to map cortical areas for epilepsy surgery.
- The trigeminal nerve innervates the face, mouth, and eyes.
Purpose of the Study:
- To investigate the origin of facial sensations elicited during cortical stimulation in epilepsy patients.
- To explore the potential role of trigeminal nerve fibers accompanying cerebral vasculature.
Main Methods:
- Twelve patients with medically intractable epilepsy underwent surgical evaluation.
- Chronic subdural electrodes were placed over lateral and basal cortical hemispheres.
- Electrical cortical stimulation was performed during the evaluation.
Main Results:
- Ipsilateral sensations in the eye, face, and mouth were reported during stimulation.
- Stimulation responses were attributed to dural, direct trigeminal nerve, or perivascular fiber activation.
- Evidence suggests trigeminal fibers accompanying pial-arachnoidal vessels may be stimulated.
Conclusions:
- Cortical stimulation can elicit trigeminal nerve sensations in epilepsy patients.
- Trigeminal nerve fibers accompanying cerebral blood vessels may be present and functional in humans.
- This finding offers new insights into neuroanatomy and sensory pathways relevant to epilepsy surgery.