Case series: non vascular considerations in trigeminal neuralgia

• Published in: Clinical oral investigations 2012-02, Vol.16 (1), p.63-68
• Main Authors: Balasundram, Sathesh, Cotrufo, Stefano, Liew, Colin
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Ameloblastoma - complications; Ameloblastoma - diagnosis; Cerebellar Diseases - complications; Cerebellar Diseases - diagnosis; Cerebellar Neoplasms - complications; Cerebellar Neoplasms - diagnosis; Cerebellopontine Angle - pathology; Cranial Nerve Neoplasms - complications; Cranial Nerve Neoplasms - diagnosis; Dentistry; Diagnosis, Differential; Epidermal Cyst - complications; Epidermal Cyst - diagnosis; Female; Follow-Up Studies; Humans; Leukemia, Hairy Cell - complications; Leukemia, Hairy Cell - diagnosis; Lymphoma, B-Cell - complications; Lymphoma, B-Cell - diagnosis; Male; Mandibular Neoplasms - complications; Mandibular Neoplasms - diagnosis; Medicine; Middle Aged; Neurilemmoma - complications; Neurilemmoma - diagnosis; Original Article; Osteochondroma - complications; Osteochondroma - diagnosis; Parotid Neoplasms - complications; Parotid Neoplasms - diagnosis; Skull Base Neoplasms - complications; Skull Base Neoplasms - diagnosis; Sphenoid Bone - pathology; Trigeminal Nerve Diseases - complications; Trigeminal Nerve Diseases - diagnosis; Trigeminal Neuralgia - diagnosis; Trigeminal Neuralgia - etiology; Young Adult
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-010-0499-2

An abnormal vascular course of the superior cerebellar artery is often cited as the cause for trigeminal neuralgia. However, among patients with TN-like symptoms, 6% to 16% are variously reported to have intracranial tumours. Aneurysms, tumours, or other lesions may impinge or irritate the trigeminal nerve along its course. Uncommonly, an area of demyelination from multiple sclerosis may be the precipitant. We would like to present a series of unusual lesions, all of which initially presented with neuralgic-like symptoms and were refractory to treatment. Collated case series with photographs and imaging are reviewed in this paper. Discussion of case presentation and management are done for evaluation. A wide range of other compressive lesions can cause trigeminal neuralgia. This paper illustrates the clinical presentation of atypical trigeminal neuralgia and emphasises the value of diagnostic imaging in trigeminal neuralgia patient. Suggested algorithm for management of trigeminal neuralgia