Abstract
Trigeminal neuralgia (TN) is a neuropathic pain disorder characterized by paroxysmal pain in the maxillary and mandibular regions of the face. Morbihan syndrome is a disease that classically presents with dermatologic findings, including progressive facial edema and erythema. There are no previous reports of the onset of trigeminal neuralgia with Morbihan syndrome or previous reports describing improvement in symptoms of Morbihan syndrome with treatment of trigeminal neuralgia. We describe the case of a 62-year-old female who presented with trigeminal neuralgia and shortly thereafter developed significant facial edema and was diagnosed with Morbihan syndrome. The neuralgia was refractory to medical management and was effectively treated with stereotactic radiosurgery (SRS). This coincided with an improvement in her Morbihan syndrome that is now controlled following stereotactic radiosurgery and continued lymphatic massage.
Highlights
Categories: Dermatology, Pain Management, Radiation Oncology Keywords: neuropathic pain treatment, stereotactic radiosurgery, morbihan syndrome, trigeminal neuralgia, stereotactic radiosurgery srs Trigeminal neuralgia (TN) is a chronic neuropathic pain disorder that classically presents with paroxysms of shock-like or stabbing pain that is spontaneous and elicited by innocuous stimuli to a region of the face [1]
There are no previously published case reports describing the onset of TN with Morbihan syndrome or describing improvement in symptoms of Morbihan syndrome with treatment of TN
We presented a case of a patient whose facial edema started one year after symptoms of TN
Summary
Trigeminal neuralgia (TN) is a chronic neuropathic pain disorder that classically presents with paroxysms of shock-like or stabbing pain that is spontaneous and elicited by innocuous stimuli to a region of the face [1]. The patient developed significant side effects from medical therapy, including fatigue, memory loss, and cognitive dysfunction She endorsed that the pain was debilitating in nature. The patient was seen in consultation by radiation oncology for consideration of SRS for her TN Her past medical history was remarkable for TN (three-year duration), fibromyalgia, migraine headaches, asthma, restless leg syndrome, and alopecia areata. The massage therapy, along with her previous SRS, resulted in a marked improvement in her symptoms of Morbihan syndrome She no longer has persistent edema and facial erythema. She experiences rare pain flares that can be controlled with simple analgesics She finds that the facial edema caused by Morbihan syndrome remains significantly improved. It can be effectively managed with gentle lymphatic massage
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