Recurrent Trigeminal Neuralgia: A Case Series and a Review of the Literature.

Harsha Vardhan,Nagammai N,Saraswathi K,Sushmitha S

doi:10.7759/cureus.22548

Abstract

Trigeminal neuralgia is a peripheral neuropathy characterized by intermittent episodes of severe facial pain originating in the sensory nucleus of the trigeminal nerve. The most commonly involved area is the mandibular division with a higher prevalence on the right side. Advances in the field of MRI have played an important role in its diagnosis, especially in presurgical assessment, to probe into any secondary causes of nerve compression and/or neurovascular conflict. The condition is primarily managed medically, although many patients may require surgical or radiotherapeutic intervention. A recurrence rate ranging from 6 to 41% has been postulated. Reasons for recurrence are mainly attributed to improper operative techniques, dislocation of the Teflon implant, or granuloma formation. MRI serves as a powerful tool in the segmental evaluation of the trigeminal nerve. A proper diagnosis with a structured treatment protocol is critical for managing such cases of trigeminal neuralgia. In this report, we present a series of two cases of recurrent trigeminal neuralgia.

Highlights

Trigeminal neuralgia is referred to as Tic douloureux, Fothergill’s disease, and suicide disease
According to the International Headache Society, trigeminal neuralgia is a condition defined by the occurrence of attacks lasting between one second and two minutes that affect several subdivisions of the trigeminal nerve with the affected individual experiencing an intense, sharp, superficial, or stabbing pain precipitated by specific triggers or actions
Even though trigeminal neuralgia is a relatively rare disease, it is often associated with debilitating pain and disability

Summary

Introduction

Trigeminal neuralgia is referred to as Tic douloureux, Fothergill’s disease, and suicide disease. Following the restoration, she experienced five intermittent episodes of electric shock-like pain in relation to the right middle-third of the face, each lasting for 10-15 seconds. The pain was triggered by washing the face and exposure to a cool breeze Her medical history revealed surgical management with MVD for the same complaint four years ago. The patient reported experiencing a similar kind of pain in the same region and in a similar fashion 10 months ago, which had led to a diagnosis of trigeminal neuralgia He had been managed with carbamazepine 200 mg and amitriptyline hydrochloride 25 mg for a period of two months, following which he discontinued the therapy without any medical intervention.

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