Trigeminal-Cervical Integration and Cerebellar Modulation in the Neurophysiology of Craniofacial Pain Craniofacial pain, sensory integration and postural control
Integración trigémino-cervical y modulación cerebelosa en la neurofisiología del dolor craneofacial Dolor craneofacial, integración sensorial y control postural
Authors: Mónica Martínez Carrasco
Keywords: Trigeminocervical complex. Cerebellum. Trigeminal nociception. Central sensitisation. Postural control
Keywords: Trigeminocervical complex. Cerebellum. Trigeminal nociception. Central sensitisation. Postural control
Abstract: The trigeminal nerve has traditionally been described in clinical practice as the motor nerve of the temporomandibular joint (TMJ) and the sensory nerve of the face, with its pathology approached almost exclusively from a dental, occlusal and masticatory perspective. The lecture “Trigeminal-cervical integration and cerebellar modulation in the neurophysiology of craniofacial pain” (congress code FTP26) starts from this common clinical assumption in order to challenge it, proposing that the trigeminal nerve be reconceptualised as the trigeminocervical complex (TCC), an elongated macro-structure that extends from the midbrain down to the upper cervical spinal cord (C4) and that functions as a genuine, high-density afferent surveillance network for the head, face and posture, rather than as an isolated peripheral nerve. Building on this anatomical foundation, the talk argues that the cerebellum — classically understood as an organ of motor coordination and balance — participates actively, not merely passively, in the computation of trigeminal pain, applying the same comparator algorithm it uses for motor control. The lecture develops this idea across five progressive blocks, moving from the anatomical architecture of the TCC to the peripheral and central sensitisation mechanism that explains its dysfunction in chronic craniofacial pain and migraine, and closing with a reflection on the implications for clinical reasoning in physiotherapy and postural control.
Abstract : El nervio trigémino ha sido tradicionalmente descrito, en el ámbito clínico, como un nervio motor de la articulación temporomandibular (ATM) y sensitivo de la cara, cuya patología suele abordarse casi exclusivamente desde el plano dental, oclusal y masticatorio. La ponencia «Integración trigémino-cervical y modulación cerebelosa en la neurofisiología del dolor craneofacial» (código de congreso FTP26) parte de esta asunción clínica habitual para desestabilizarla, proponiendo reconceptualizar el trigémino como el complejo trigémino-cervical (CCT), una macroestructura elongada que se extiende desde el mesencéfalo hasta la médula espinal cervical alta (C4) y que actúa como una auténtica red aferente de vigilancia craneofacial y postural de alta densidad, más que como un nervio periférico aislado. Sobre esta base anatómica se plantea que el cerebelo, entendido clásicamente como órgano de coordinación motora y equilibrio, participa de forma activa —y no meramente pasiva— en el cómputo del dolor trigeminal, aplicando el mismo algoritmo comparador que emplea en el control motor. Esta ponencia articula esta idea en cinco bloques progresivos que avanzan desde la arquitectura anatómica del CCT hasta el mecanismo de sensibilización periférica y central que explica su disfunción en el dolor craneofacial crónico y en la migraña, cerrando con una reflexión sobre las implicaciones para el razonamiento clínico en fisioterapia y el control postural.
10-09-2026
Mónica Martínez Carrasco
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| Citation: Mónica Martínez Carrasco. Integración trigémino-cervical y modulación cerebelosa en la neurofisiología del dolor craneofacial Dolor craneofacial, integración sensorial y control postural. https://doi.org/10.24175/sbd.2026.000041 |
| Received: September 10, 2026 Accepted: September 10, 2026 Published: September 10, 2026 |
| Copyright: © 2026 Mónica Martínez Carrasco. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC), which allows, distribution, reproduction in any medium, provided the original author and source are credited and non-commercial use. |
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