Idiopathic and Seemingly Idiopathic Neuralgia of Nervus Trigeminus
Authors:
J. Kovaľ; S. Krempaská; M. Andrašovská
Authors‘ workplace:
Klinika otorinolaryngológie a chirurgie hlavy LF UPJŠ a UN L. Pasteura, Košice, prednosta prof. MUDr. J. Kovaľ, CSc.
Published in:
Otorinolaryngol Foniatr, 60, 2011, No. 3, pp. 145-151.
Category:
Original Article
Overview
The paper presents an analysis of 8 patients, who suffered with neuralgia of n. trigeminus, which had been considered as idiopathic. In 7 of them NMR examination gave a possible cause, which was subsequently confirmed by surgery. In one case the pain was caused by epidermoid in pontocerebellar angle, the removal of which resulted in disappearance of the pain. In six cases NMR visualized a neurovascular conflict of the fifth nerve, which was also confirmed during the surgery. The microvascular decompression of n. V resulted in disappearance of the neuralgic pain in all these patients. In one case there was a neurovascular conflict on n.V, but the microvascular decompression was not successful. One year later, this patient was operated on again using partial rhizotomy, which was followed by disappearance of the pain. From the 8 patients, who underwent neuralgia of n. trigeminus for many years under the diagnosis of the idiopathic form, it has become obvious that it was actually the secondary form of n. V (once a tumor in the pontocerebellar angle, six times a neurovascular conflict) and only in one case of unsuccessful microvascular decompression after an obvious separation of the nerve from the vascular structures the case was indeed an idiopathic neuralgia. In two patients who had been treated for a long time for neuralgia of n. V also also for multiple sclerosis, the neuralgia ceased after microvascular decompression. Apparently, sclerosis multiplex does not necessarily be the absolute cause, but it can be a neurovascular conflict.
Key words:
idiopathic neuralgia of nervus trigeminus, neurovascular conflict, microvascular decompression, sclerosis multiplex, epidermoid in pontocerebellar angle.
Sources
1. Benes, L., Shiratori, K., Gurschi, M. et al.: Is preroperative high-resolution magnetic resonance imaging accurate in predicting neurovascular compression in patients with trigeminal neuralgia? Neurosurg. Rev., 28, 2005, s. 131-136.
2. Broggi, G., Ferroli, P., Franzini A. et al.: Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases, including 10 patients with sclerosis multiplex. J. Neurol. Neurosurg. Psychiatry, 68, 2000, s. 59-64.
3. Choudhari, K.: Superior petrosal vein in trigeminal neuralgia. B. J. Neurosurg., 21, 2007, 3, s. 288-292.
4. El - Garem, H., Badr-El-Dine, M., Talaat, A., Magnan, J.: Endoscopy as a tool in minimally invasive trigeminal neuralgia surgery. Otol. Neurotol., 23, 2002, 2, s. 132-135.
5. Elaiani, S., Miyazaki, H., Rameh, C., Deveze, A., Magnan, J.: Correlation between magnetic resonance imaging and surgical finding in vasculo-neural compression syndrome. IAO 5, 2009, 3,(Suppl. 3), s. 1-23.
6. Fukushima, T.: Microvascular decompression for hemifacial spasm and trigeminal neuralgia: results in 4000 cases. J. Neurol. Neurosurg. Psych., 53, 1990, s. 173-182.
7. Haines, S., Jannetta, P., Zorub, D.: Microvascular relations of the trigeminal nerve. An anatomical study with clinical correlation. J. Neurosurg., 52, 1980, s. 381-386.
8. Jackler, R., Brackmann, D.: Neurotology. Mosby, St. Louis, 1994, 1464 s.
9. Jannetta, P., Rand, R.: Arterial compression of the trigeminal nerve at the pons in the patients with trigeminal neuralgia. J. Neurosurg., 26, 1967, s. 159-163.
10. Jannerra, P.: Microsurgery of cranial nerve cross-compression. Clin. Neurosurg., 26, 1979, s. 607-615.
11. Kovaľ, J., Krempaská, S., Kaliarik, L.: Minimálny transemisárny retrosigmoidný prístup s využitím endoskopie. Otorinolaryng. a Foniat. /Prague/, 58, 2009, 1, s. 8-14.
12. Love, S., Coakham, H.: Trigeminal neuralgia - Pathology and pathogenesis. Brain, 124, 2001, 12, s. 2347-2360.
13. Magnan, J., Chays, A., Leptre, C. et al.: Surgical perspective of endoscopy of the cerebellopontine angle. Am. J. Otol., 15, 1994, s. 366-370.
14. Magnan, J., Chays, A., Broder, L. et al.: Le traitement des conflits arteres-nerf dans lęangle pontocerrebeleux. Radiologie, 19, 1999, 2, s. 63-72.
Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
2011 Issue 3
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