Nose to brain: Is the trigeminal nerve a conduit for CNS disease?

Abstract

Trigeminal neuralgia (TN) and sensory fifth cranial nerve effects occurring in patients with multiple sclerosis (MS) have been investigated using conventional diagnostic MRI ( Da Silva et al., 2005 Da Silva CJ da Rocha AJ Mendes MF Maia Jr, AC Braga FT Tilbery CP Trigeminal involvement in multiple sclerosis: magnetic resonance imaging findings with clinical correlation in a series of patients. Multiple Sclerosis (Houndmills, Basingstoke, England). 2005; 3: 282-285 Crossref Scopus (55) Google Scholar ) and more recently using high resolution MRI at 3 T ( Mills et al., 2010 Mills RJ Young CA Smith ET Central trigeminal involvement in multiple sclerosis using high-resolution MRI at 3 T. The British Journal of Radiology. 2010; 83: 493-498 Crossref PubMed Scopus (43) Google Scholar ). Signal abnormalities in the trans-cisternal nerve and in the pontine root entry zone were detected in approximately 3% of patients with a history of TN on conventional imaging, but in the series of randomly chosen MS patients examined at 3 T, 11/47 (23%) showed high signals in these structures, without any corresponding clinical association.