Evaluation Of Trigeminal Neuralgia Research Articles

Role of Magnetic Resonance Imaging in the Evaluation of Trigeminal Neuralgia Using Steady-State Imaging.

Trigeminal neuralgia (TN) poses diagnostic challenges due to its complex origins, often associated with neurovascular compression. Advanced imaging techniques, particularly magnetic resonance imaging (MRI) with thefast imaging employing steady-state acquisition (FIESTA) sequence, offer crucial insights into TN pathophysiology. This prospective cross-sectional observational study aimed to elucidate MRI's utility in diagnosing TN and correlating imaging findings with clinical manifestations and treatment outcomes. A cohort of 41 patients clinically suspected of TN underwent MRI evaluation at Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, utilizing various sequences including FIESTA. Analysis revealed a higher incidence among females, predominant unilateral presentation, and a higher prevalence of abnormal MRI findings, with neurovascular compression as the leading etiology. Correlation analysis demonstrated significant associations between facial pain localized to the trigeminal nerve distribution, triggering factors, and abnormal MRI findings. Gender distribution did not significantly influence MRI findings. Treatment outcomes favored microvascular surgery over conservative management in cases of neurovascular compression. This study underscores MRI's pivotal role, particularly FIESTA, in TN evaluation, guiding personalized treatment strategies and emphasizing the importance of integrated clinical and imaging approaches. Further research is warranted to validate these findings and explore additional imaging modalities for a deeper understanding of TN pathogenesis.

The Role of Magnetic Resonance Imaging in the evaluation of Trigeminal Neuralgia: a pilot study

Introduction Trigeminal neuralgia is a debilitating painful condition affecting one or more branches of trigeminal nerve characterized by sharp shooting, electric shock like pain lasting for a short time. In most cases, no specific cause can be identified but certain do tend to occur due to lesions or damage to the trigeminal nerve due to vascular compression, tumors, etc. which can be detected by magnetic resonance imaging. Hence, this pilot study was conducted to identify any underlying causes for trigeminal neuralgia using magnetic resonance imaging. Methods A prospective cross-sectional descriptive study was conducted on 10 patients who were presented to department with clinical symptoms of trigeminal neuralgia. Magnetic resonance imaging of the brain with trigeminal protocol was conducted. The evaluation of the entire course of the trigeminal nerve was then performed by an experienced radiologist. Results Out of the 10 patients, 6 were females and 4 males. Four patients did not show presence of any pathology i.e. were idiopathic. Five cases reported with neurovascular compression and one showed the presence of a tumor at the cerebellopontine angle compressing the nerve. Conclusion In this study, with use of magnetic resonance imaging, a 60% occurrence of an underlying pathology was demonstrated which could be treated to relieve the neuralgia. Hence, taking into account the high prevalence of etiological factors which could contribute towards trigeminal neuralgia detected on MRI, large scale studies can be considered for the same.

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Role of Magnetic Resonance Imaging in Evaluation of Trigeminal Neuralgia with its Anatomical Correlation

Neuropathic Pain is caused by a primary lesion or dysfunction of the peripheral or central nervous system. Trigeminal neuralgia is one such disease which is characterized by episodes of unilateral, lancinating, shock- like pains and are also intermixed with pain free episodes. It has a primary or classic and secondary type. Primary TN is due to neurovascular compression whereas secondary TN is due to any tumor in the brain stem. Trigeminal nerve has a sensory and motor root arising from the pons and travels to the face where it ends as three branches namely ophthalmic, maxillary and mandibular. Magnetic resonance Imaging is a gold in identifying these lesions. However, it is not always prescribed due to lack of insight in using MRI as an evaluating tool. It results in over dosage of medication as the physician prescribes the drug without identifying whether the lesion is primary or secondary. This article give an insight on the various MRI sequences imaged various studies available and also throws light on other sequence which has to be explored in this disease.

The Role of Magnetic Resonance Imaging in the Evaluation of Trigeminal Neuralgia

The Role of Magnetic Resonance Imaging in the Evaluation of Trigeminal Neuralgia

The Role of Magnetic Resonance Imaging in the Evaluation of Trigeminal Neuralgia

The Role of Magnetic Resonance Imaging in the Evaluation of Trigeminal Neuralgia

Neuralgia del trigémino: estudio funcional mediante tensor de difusión de alta densidad como herramienta diagnóstica

ObjectiveThe objective of this article is to demonstrate the alteration of the anisotropy factor (FA) in essential trigeminal neuralgia. Materials and methodsTen patients with essential trigeminal neuralgia were studied with sequences of high density diffusion tensor and anatomic 3D images with a high-field 3 Tesla resonator. The nerves were located in all cases studied. The obtained images were post-processed to perform tractography and FA was measured in 20 nerves. ResultsThere was correlation of pathological findings between measuring FA and clinical presentation of the patients. Six of the ten patients studied with neurovascular compression at the neuralgia side had decreased FA values compared to contralateral normal range. Two of the ten patients showed bilateral neurovascular compression, but only abnormal values of FA were found at the clinically affected side. In the remaining two patients no neurovascular compression was determined; however the FA was lower at the clinical manifestation neuralgic side. ConclusionThe performing of high density anisotropic diffusion and the measurement of the FA may be useful in the evaluation of Trigeminal neuralgia, since it is a safe and reproducible method that allows the study of nerve function.

Magnetic resonance imaging of vertebrobasilar ectasia in trigeminal neuralgia.

Vertebrobasilar ectasia is a rare cause of typical trigeminal neualgia. In a recently published large series only thirty-one (2%) of 1404 consecutive patients with vascularly determined neuralgia were found to have vertebrobasilar compression. We present three patients with trigeminal neuralgia caused by vertebrobasilar ectasia, who were evaluated with high resolution magnetic resonance imaging (MRI). MRI studies provided accurate information on the anatomical location and course of the ectatic vessel in the cerebellopontine angle and the caused mass effect on the brainstem. With gadolinium-enhancement vascular compression of the trigeminal nerve was demonstrated clearly. Surgery confirmed compression of the fifth nerve by an ectatic and tortuous vertebrobasilar artery in two cases. Following microvascular decompression neither patient experienced further pain. The third patient was treated with a ventriculoperitoneal shunt, as he developed occlusive hydrocephalus caused by the vertebrobasilar dolicho-ectasia. MRI is useful in the evaluation of trigeminal neuralgia as it excludes other aetiologies such as tumour or arteriovenous malformation, but also demonstrates cranial nerve compression by ectatic vertebral arteries.

Magnetic resonance imaging used to assess patients with trigeminal neuralgia

To assess the value of magnetic resonance imaging in the evaluation of trigeminal neuralgia, 51 patients were studied by magnetic resonance imaging after a trigeminal protocol. Clinical and magnetic resonance imaging results were correlated. Seventeen (33%) nonvascular abnormalities and 27 (53%) vascular contacts or compressions of the trigeminal nerve were demonstrated. Of the patients younger than of 29 and 39 years of age, 100% and 45%, respectively, had a tumor or multiple sclerosis compared with 20% and 18% of those older than 40 and 60 years of age, respectively. One third of the patients with pain in more than one branch of the trigeminal nerve had tumors. On the basis of this study, magnetic resonance imaging may be useful in discovering underlying pathoses associated with trigeminal neuralgia if patients have failed to respond to an initial conservative treatment. The patients most likely to exhibit significant magnetic imaging resonance findings are young and with pain in more than one trigeminal branch.

Hypothyroidism with Ascites

Incorrect etiopathological evaluation of trigeminal neuralgia could result in therapeutic mistakes. Some of the clinical cases encountered are reviewed to point out diagnosis leading to valid therapeutic approaches.