90 Cranial Nerves

Central Sensory Nuclei

All three divisions of the trigeminal nerve, ophthalmic, maxillary, and
mandibular, join together at the trigeminal ganglion where most of the sensory
nerve cell bodies reside. Central processes of these neurons constitute the
sensory root of the trigeminal nerve, which enters the pons at its midlateral
point. The axons terminate by synapsing with second-order sensory neurons in
the appropriate region of the trigeminal nucleus.
The trigeminal nucleus (sensory nucleus of the trigeminal nerve) is the
largest of the cranial nerve nuclei. It extends caudally from the midbrain into
the spinal cord as far as the second cervical segment where it becomes
continuous with the dorsal horn of the spinal cord (Figure V— 8 ). Within the
medulla it creates a lateral elevation — the tuberculum cinereum. It has three
subnuclei: the mesencephalic nucleus, the pontine trigeminal (chief sensory)
nucleus, and the spinal nucleus of the trigeminal nerve (Figures V— 8 and V—
9).

The pontine trigeminal nucleus is known by a wide variety of

names including the main, principal, chief, or superior
trigeminal nucleus. In this text, we have chosen to use
"pontine" to indicate its location, thereby maintaining
consistency with the names of the other two subnuclei.

The mesencephalic trigeminal nucleus consists of a thin column of

primary sensory neurons. Their peripheral processes, which travel with the
motor nerves, carry proprioceptive information from the muscles of
mastication. Their central processes project mainly to the motor nucleus of
cranial nerve V (masticator nucleus) to provide for reflex control of the bite.
The pontine trigeminal nucleus is a large group of secondary sensory
neurons located in the pons near the point of entry of the nerve. It is
concerned primarily with discriminative touch sensation from the face.
The nucleus of the spinal trigeminal nerve, or spinal trigeminal nucleus, is
a long column of cells extending from the pontine trigeminal nucleus caudally
into the spinal cord where it merges with the dorsal gray matter of the spinal
cord (Figure V—10). This subnucleus, especially its caudal portion, is
concerned primarily with the perception of pain and temperature, although
tactile information is projected to this subnucleus as well as to the pontine
trigeminal nucleus. Axons of trigeminal nucleus neurons project to the
contralateral sensory cortex via the thalamus, as detailed below.