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AlHatmi A, Al-Qassabi A, Raniga SB, Al Ajmi E. Absence of Meckel's Cave with Trigeminal Neuralgia: A Case Report. Indian J Radiol Imaging 2022; 33:124-128. [PMID: 36855729 PMCID: PMC9968541 DOI: 10.1055/s-0042-1759638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Trigeminal neuralgia (TN) is a disabling painful condition along the course of the sensory distribution of the trigeminal nerve that most commonly occurs due to vascular compression or conflict at the root entry zone of the trigeminal nerve. We report a 27-year-old female patient who presented with pain and an electric shock-like sensation on the right side of her face that started three years ago. Magnetic resonance imaging of the brain was done and revealed no neurovascular conflict along the course of the trigeminal nerve. The absence of Meckel's cave with atrophy of the cisternal segment of the trigeminal nerve on the affected side was reported. The absence of Meckel's cave is an exceedingly rare cause of TN, and only a handful of reported cases in the literature suggest the association between them.
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Affiliation(s)
- Asma AlHatmi
- Department of Radiology, Ibri Hospital, Ibri, Oman
| | - Ahmed Al-Qassabi
- Division of Neurology, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Al-Khoudh, Oman
| | - Sameer Bhimjibhai Raniga
- Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Al-Khoudh, Oman
| | - Eiman Al Ajmi
- Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Al-Khoudh, Oman,Address for correspondence Eiman Al Ajmi, MD, FRCPC, FRCR Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Sultan Qaboos UniversityMuscat, Al-Khoudh 123Oman
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Neurotrophic Keratitis Due to Congenital Corneal Anesthesia with Deafness, Hypotonia, Intellectual Disability, Face Abnormality and Metabolic Disorder: A New Syndrome? Medicina (B Aires) 2022; 58:medicina58050657. [PMID: 35630074 PMCID: PMC9147521 DOI: 10.3390/medicina58050657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/08/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022] Open
Abstract
Neurotrophic keratitis is a rare degenerative disease of the cornea that can lead to corneal ulceration, scarring, and significant visual impairment. It most commonly occurs in adults and is rarely diagnosed in children. Congenital corneal anesthesia is an extremely rare condition that requires appropriate ophthalmologists’ attention in making diagnosis and treatment decisions. This condition usually presents in infancy or early childhood and is characterized by rare blinking rate, decreased tearing or a corneal ulcer that is unresponsive to treatment. In this case report, we describe a patient with multiple systemic and neurological disorders who presented to the ophthalmology department due to corneal erosion unresponsive to treatment. Brain magnetic resonance imaging confirmed bilateral trigeminal hypoplasia and the diagnosis of neurotrophic keratopathy due to bilateral congenital corneal anesthesia was made. The discrepancy between clinical signs and symptoms or treatment non-response in cases of corneal erosions should alert the ophthalmologists to suspect trigeminal dysfunction. MRI is the gold standard to confirm congenital corneal anesthesia and to differentiate from other possible neurotrophic keratitis causes.
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Freddi TDAL, Ottaiano AC, Lucio LL, Corrêa DG, Hygino da Cruz LC. The Trigemius Nerve: Anatomy and Pathology. Semin Ultrasound CT MR 2022; 43:403-413. [DOI: 10.1053/j.sult.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Jain A, Muneer MS, Okromelidze L, McGeary R, Valluri SK, Bhatt AA, Gupta V, Grewal SS, Cheshire WP, Middlebrooks EH, Sandhu SJS. Absence of Meckel Cave: A Rare Cause of Trigeminal Neuralgia. AJNR Am J Neuroradiol 2021; 42:1610-1614. [PMID: 34244131 DOI: 10.3174/ajnr.a7205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/20/2021] [Indexed: 11/07/2022]
Abstract
Trigeminal neuralgia is a debilitating condition with numerous etiologies. In this retrospective case series, we report a cohort of patients with a rarely described entity, absence of Meckel cave, and propose this as a rare cause of trigeminal neuralgia. A search of the electronic medical record was performed between 2000 and 2020 to identify MR imaging reports with terms including "Meckel's cave" and "hypoplasia," "atresia," "collapse," or "asymmetry." Images were reviewed by 2 blinded, board-certified neuroradiologists. Seven cases of the absence of Meckel cave were identified. Seven patients (100%) had ipsilateral trigeminal neuralgia and ipsilateral trigeminal nerve atrophy, suggesting an association between absence of Meckel cave and trigeminal neuralgia. Absence of Meckel cave is a rare entity of unknown etiology, with few existing reports that suggest the possibility of an association with trigeminal neuralgia. Its recognition may have important implications in patient management. Future studies and longitudinal data are needed to assess treatment outcomes and added risks from surgical intervention in these patients.
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Affiliation(s)
- A Jain
- From the Departments of Radiology (A.J., M.S.M., L.O., R.M., S.K.V., A.A.B., V.G., E.H.M., S.J.S.S.)
| | - M S Muneer
- From the Departments of Radiology (A.J., M.S.M., L.O., R.M., S.K.V., A.A.B., V.G., E.H.M., S.J.S.S.)
| | - L Okromelidze
- From the Departments of Radiology (A.J., M.S.M., L.O., R.M., S.K.V., A.A.B., V.G., E.H.M., S.J.S.S.)
| | - R McGeary
- From the Departments of Radiology (A.J., M.S.M., L.O., R.M., S.K.V., A.A.B., V.G., E.H.M., S.J.S.S.)
| | - S K Valluri
- From the Departments of Radiology (A.J., M.S.M., L.O., R.M., S.K.V., A.A.B., V.G., E.H.M., S.J.S.S.)
| | - A A Bhatt
- From the Departments of Radiology (A.J., M.S.M., L.O., R.M., S.K.V., A.A.B., V.G., E.H.M., S.J.S.S.)
| | - V Gupta
- From the Departments of Radiology (A.J., M.S.M., L.O., R.M., S.K.V., A.A.B., V.G., E.H.M., S.J.S.S.)
| | | | - W P Cheshire
- Neurology (W.P.C.), Mayo Clinic, Jacksonville, Florida
| | - E H Middlebrooks
- From the Departments of Radiology (A.J., M.S.M., L.O., R.M., S.K.V., A.A.B., V.G., E.H.M., S.J.S.S.) .,Neurosurgery (S.S.G., E.H.M.)
| | - S J S Sandhu
- From the Departments of Radiology (A.J., M.S.M., L.O., R.M., S.K.V., A.A.B., V.G., E.H.M., S.J.S.S.)
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Li X, Yue J, Yang L, Yang H, Zheng S, He L, Ni J. Application of Antidromic Conduction Monitoring in Ganglion Radiofrequency Thermocoagulation for Locating Trigeminal Branches in Trigeminal Neuralgia. Pain Pract 2015; 16:305-10. [PMID: 25727990 DOI: 10.1111/papr.12286] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 11/09/2014] [Accepted: 11/28/2014] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to investigate whether antidromic conduction monitoring (ACM) can be utilized to map the trigeminal system under sedation as a potential substitute for subjective paresthesia description (SPD) during percutaneous ganglion radiofrequency thermocoagulation (PGRT). METHODS Eighty-two patients with 152 pain divisions of trigeminal neuralgia (TN) were treated by computed tomography (CT)-guided PGRT. After the puncture needle entered the foramen ovale (FO), sensory and motor stimulation were applied to locate the pain division. And the corresponding voltage values were recorded by patients' SPD. In the following, the proper location was certified by ACM. The corresponding earliest waves and voltage values in the identified trigeminal branch were also recorded to outline a comparison between two methods. RESULTS The correlation of ACM and patients' SPD with voltage at ≤ 0.5 V was statistically significant (P < 0.05, r = 0.159; Spearman's rank correlation analysis). Although ACM and SPD showed weak correlation, as their interclass correlation coefficient was significant (F = 1.868, P < 0.01) with coefficient of internal consistency. Moreover, the two methods had consistency. Kruskal-Wallis test showed that ophthalmic (V1), maxillary (V2), and mandibular (V3) divisions had significant differences for test sensitivity (H = 15.945, P < 0.01). For comparison of sensitivities with ACM, V3 was most sensitive followed by V2 and then V1. CONCLUSION ACM could potentially substitute for SPD of the paresthesias intra-operatively, enabling greater specificity and eliminating the need to interrupt the administration of anesthetic. These improvements would increase patient satisfaction and practitioner efficiency and accuracy.
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Affiliation(s)
- Xiuhua Li
- Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Jianning Yue
- Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Liqiang Yang
- Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Huijie Yang
- Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Shuyue Zheng
- Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Liangliang He
- Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Jiaxiang Ni
- Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China
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Choudhri AF, Patel RM, Wilroy RS, Pivnick EK, Whitehead MT. Trigeminal nerve agenesis with absence of foramina rotunda in Gómez-López-Hernández syndrome. Am J Med Genet A 2014; 167A:238-42. [DOI: 10.1002/ajmg.a.36830] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 09/16/2014] [Accepted: 09/19/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Asim F. Choudhri
- Department of Radiology; University of Tennessee Health Science Center; Memphis Tennessee
- Department of Ophthalmology; University of Tennessee Health Science Center; Memphis Tennessee
- Department of Neurosurgery; University of Tennessee Health Science Center; Memphis Tennessee
- Le Bonheur Children's Hospital; Memphis Tennessee
| | - Rakesh M. Patel
- College of Medicine; University of Tennessee Health Science Center; Memphis Tennessee
| | - Robert S. Wilroy
- Le Bonheur Children's Hospital; Memphis Tennessee
- Department of Pediatrics; Division of Genetics; University of Tennessee Health Science Center; Memphis Tennessee
| | - Eniko K. Pivnick
- Department of Ophthalmology; University of Tennessee Health Science Center; Memphis Tennessee
- Le Bonheur Children's Hospital; Memphis Tennessee
- Department of Pediatrics; Division of Genetics; University of Tennessee Health Science Center; Memphis Tennessee
| | - Matthew T. Whitehead
- Department of Radiology; University of Tennessee Health Science Center; Memphis Tennessee
- Le Bonheur Children's Hospital; Memphis Tennessee
- Department of Radiology; Children's National Medical Center; Washington DC
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