Atypical Trigeminal Neuralgia Secondary to Meningioma.

Premeshwar Niwant,Mukta Motwani,Sushil Naik

doi:10.1155/2015/462569

Premeshwar Niwant, Mukta Motwani + Show 1 more

Open Access

https://doi.org/10.1155/2015/462569

Copy DOI

Abstract

Trigeminal neuralgia is a disorder of the fifth cranial nerve that causes episodes of intense, stabbing, electric shock-like pain that lasts from few seconds to few minutes in the areas of the face where the branches of the nerve are distributed. More than one nerve branch can be affected by the disorder. We report an unusual case of trigeminal neuralgia affecting right side of face presenting atypical features of neuralgia and not responding to the usual course of treatment. The magnetic resonance imaging study of brain revealed a large extra-axial mass involving right cerebellopontine angle region causing moderate pressure effect on trigeminal nerve and brain stem. The aim of this case report is to show a tumor of cerebellopontine angle, presenting clinically as atypical trigeminal neuralgia.

Highlights

Trigeminal neuralgia (TN), known as prosopalgia [1], suicide disease [2], or Fothergill’s disease [3], is a neuropathic disorder characterized by episodes of intense pain in the face, originating from the branches of the trigeminal nerve
The behavioral characteristics of the pain are neurogenous. All these findings were suggestive of trigeminal neuralgia but as the patient was not responding to the usual course of treatment and the severity of pain increases, an intracranial pathology was suspected in this case
The present case report focuses on the fact that the eyes cannot see what the mind does not know

Summary

Introduction

Trigeminal neuralgia (TN), known as prosopalgia [1], suicide disease [2], or Fothergill’s disease [3], is a neuropathic disorder characterized by episodes of intense pain in the face, originating from the branches of the trigeminal nerve. Of the superior cerebral artery causing demyelization and pressure of the aneurysms of the intrapetrous portion of the internal carotid artery causing irritation of the trigeminal ganglion leading to paroxysmal trigeminal neuralgia are recently blamed causes of idiopathic TN. Many lesions such as trigeminal neuromas in the middle cranial or the posterior fossa, epidermoid tumors, Meckle’s cave, arteriovenous malformations, aneurysms, and vascular compression have been suggested as the causes. Many patients present with less classic symptoms and may mimic toothache, sinusitis, stomatitis, or other inflammatory conditions and for diagnosis of neuralgic pain, proper clinical examination along with thorough history is mandatory.

Case Report

Findings

Discussion

Conclusion