三叉神经痛(CH)的机理所知甚少。由三叉神经纤维输入,经面神经自主通路输出的反射弧,特别是以P物质为介质的三叉神经C纤维和局部轴突反射对其发作可能起重要作用。疼痛发作的周期性、面部皮肤肥大细胞数增加以及类固醇药物治疗有效提示以反复发作为特征的感染是一种病因。疱疹病毒(如唇单纯疱疹)可侵犯三叉神经节并在此建立潜伏性感染。单纯疱疹的间歇性复发便是这种潜伏性感染激活的结果。一位32岁男性,1973年起有慢性继发性左侧CH,每天发作1～2次,持续约1小时,除用大剂量类固醇外,其他药物均无效。半月神经结后注射甘油可暂时止痛。曾出现和CH复发一致的唇部疱疹。最近一次 Little is known about the mechanism of trigeminal neuralgia (CH). Reflex arcs output by the trigeminal nerve fibers via the autonomic pathway of the facial nerve, especially the trigeminal C fibers with focal substance substance P and local axonal reflexes may play an important role in the attack. Periodic pain episodes, an increase in the number of facial skin mast cells, and steroid therapy are effective as an etiology of infections characterized by recurrent episodes. Herpes viruses (such as lip herpes simplex) can invade the trigeminal ganglion and establish a latent infection there. Intermittent recurrent herpes simplex is the result of this latent infection. A 32-year-old man has a chronic secondary left CH since 1973. It attacks once or twice a day for about 1 hour. Other than high-dose steroids, the other drugs are ineffective. Injection of glycerol after half-moon nerve junction can temporarily relieve pain. Had appeared consistent with recurrent CH herpes zoster. The last time