|
KMID : 1141120200060020100
|
|
The Nerve
2020 Volume.6 No. 2 p.100 ~ p.104
|
|
|
Idiopathic Trigeminal Neuralgia Misdiagnosed as Secondary Trigeminal Neuralgia Caused by Neurogenic Tumor in the Infratemporal Fossa: A Case Report
|
|
Cha Jun-Yong
Son Byung-Chul
|
|
|
Abstract
|
|
|
|
A 64-year-old male patient presented with a 7-year history of chronic paroxysmal, stabbing, and electrical shock-like pain involving his mandibular nerve. After 1 year of successful medical treatment with carbamazepine, the pain was not controlled. Magnetic resonance imaging (MRI) revealed a small mass around the peripheral course of the right trigeminal nerve in the infratemporal fossa. The patient’s trigeminal pain was very similar to that of classical trigeminal neuralgia. However, radiosurgery was performed to manage the infratemporal mass around the right trigeminal nerve. Despite the radiation therapy, pain worsened and became unbearably in the next six months. A suboccipital approach was performed for microvascular decompression of the neurovascular conflict, or an intradural sensory rhizotomy to block the transmission of the tumor pain. Typical neurovascular compression by the superior cerebellar artery was confirmed and only microvascular decompression was performed. The trigeminal pain that persisted for 7 years was resolved after the surgery. Even if a mass lesion located close to the peripheral course of the trigeminal nerve, possibility of classical trigeminal neuralgia due to neurovascular compression should be suspected if there is no direct involvement of the trigeminal nerve by the mass and the nature of trigeminal pain is consistent with classical trigeminal neuralgia.
|
|
|
KEYWORD
|
|
|
Cancer pain, Microvascular decompression surgery, Pain, Trigeminal neuralgia
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|