Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1995 Sep;59(3):253–259. doi: 10.1136/jnnp.59.3.253

Association between trigeminal neuralgia and multiple sclerosis: role of magnetic resonance imaging.

J F Meaney 1, J W Watt 1, P R Eldridge 1, G H Whitehouse 1, J C Wells 1, J B Miles 1
PMCID: PMC486023  PMID: 7673952

Abstract

Seven consecutive patients with multiple sclerosis and trigeminal neuralgia were investigated with MRI to determine the occurrence of a lesion which would account for the patients' pain. Two patients had bilateral symptoms. In the patients with unilateral trigeminal neuralgia vascular compression of the nerve by an artery at the root entry zone on the symptomatic side was confirmed in three patients and an epidermoid tumour distorting the nerve on the symptomatic side was identified in one patient. A demyelinating plaque was identified in only one patient, affecting the trigeminal nerve at the root entry zone at the pons. In those with bilateral symptoms neurovascular compression was identified on both sides in one patient and on one side only in the remaining patient. Microvascular decompression cured the pain in two patients with neurovascular compression. The variable aetiology of trigeminal neuralgia is stressed even in patients with coexistent neurological conditions such as multiple sclerosis, which can cause trigeminal neuralgia independent of other causes.

Full text

PDF
253

Images in this article

254Image
on p.254
255Image
on p.255
256Image
on p.256
257Image
on p.257

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adler C. H., Zimmerman R. A., Savino P. J., Bernardi B., Bosley T. M., Sergott R. C. Hemifacial spasm: evaluation by magnetic resonance imaging and magnetic resonance tomographic angiography. Ann Neurol. 1992 Oct;32(4):502–506. doi: 10.1002/ana.410320404. [DOI] [PubMed] [Google Scholar]
  2. Ballantyne E. S., Page R. D., Meaney J. F., Nixon T. E., Miles J. B. Coexistent trigeminal neuralgia, hemifacial spasm, and hypertension: preoperative imaging of neurovascular compression. Case report. J Neurosurg. 1994 Mar;80(3):559–563. doi: 10.3171/jns.1994.80.3.0559. [DOI] [PubMed] [Google Scholar]
  3. Brett D. C., Ferguson G. G., Ebers G. C., Paty D. W. Percutaneous trigeminal rhizotomy. Treatment of trigeminal neuralgia secondary to multiple sclerosis. Arch Neurol. 1982 Apr;39(4):219–221. doi: 10.1001/archneur.1982.00510160025004. [DOI] [PubMed] [Google Scholar]
  4. Brisman R. Trigeminal neuralgia and multiple sclerosis. Arch Neurol. 1987 Apr;44(4):379–381. doi: 10.1001/archneur.1987.00520160021008. [DOI] [PubMed] [Google Scholar]
  5. Burchiel K. J. Abnormal impulse generation in focally demyelinated trigeminal roots. J Neurosurg. 1980 Nov;53(5):674–683. doi: 10.3171/jns.1980.53.5.0674. [DOI] [PubMed] [Google Scholar]
  6. Calvin W. H., Loeser J. D., Howe J. F. A neurophysiological theory for the pain mechanism of tic douloureux. Pain. 1977 Apr;3(2):147–154. doi: 10.1016/0304-3959(77)90078-1. [DOI] [PubMed] [Google Scholar]
  7. Chakravorty B. G. Association of trigeminal neuralgia with multiple sclerosis. Arch Neurol. 1966 Jan;14(1):95–99. doi: 10.1001/archneur.1966.00470070099012. [DOI] [PubMed] [Google Scholar]
  8. Cheng T. M., Cascino T. L., Onofrio B. M. Comprehensive study of diagnosis and treatment of trigeminal neuralgia secondary to tumors. Neurology. 1993 Nov;43(11):2298–2302. doi: 10.1212/wnl.43.11.2298. [DOI] [PubMed] [Google Scholar]
  9. Dieckmann G., Veras G., Sogabe K. Retrogasserian glycerol injection or percutaneous stimulation in the treatment of typical and atypical trigeminal pain. Neurol Res. 1987 Mar;9(1):48–49. doi: 10.1080/01616412.1987.11739771. [DOI] [PubMed] [Google Scholar]
  10. Fazekas F., Offenbacher H., Fuchs S., Schmidt R., Niederkorn K., Horner S., Lechner H. Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis. Neurology. 1988 Dec;38(12):1822–1825. doi: 10.1212/wnl.38.12.1822. [DOI] [PubMed] [Google Scholar]
  11. Fromm G. H., Chattha A. S., Terrence C. F., Glass J. D. Role of inhibitory mechanisms in trigeminal neuralgia. Neurology. 1981 Jun;31(6):683–687. doi: 10.1212/wnl.31.6.683. [DOI] [PubMed] [Google Scholar]
  12. Fromm G. H., Terrence C. F., Maroon J. C. Trigeminal neuralgia. Current concepts regarding etiology and pathogenesis. Arch Neurol. 1984 Nov;41(11):1204–1207. doi: 10.1001/archneur.1984.04050220102026. [DOI] [PubMed] [Google Scholar]
  13. Furuya Y., Ryu H., Uemura K., Sugiyama K., Isoda H., Hasegawa S., Takahashi M., Kaneko M. MRI of intracranial neurovascular compression. J Comput Assist Tomogr. 1992 Jul-Aug;16(4):503–505. doi: 10.1097/00004728-199207000-00001. [DOI] [PubMed] [Google Scholar]
  14. HARRIS W. Rare forms of paroxysmal trigeminal neuralgia, and their relation to disseminated sclerosis. Br Med J. 1950 Nov 4;2(4687):1015–1019. doi: 10.1136/bmj.2.4687.1015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Jannetta P. J. Neurovascular compression in cranial nerve and systemic disease. Ann Surg. 1980;192(4):518–525. doi: 10.1097/00000658-198010000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. KUGELBERG E., LINDBLOM U. The mechanism of the pain in trigeminal neuralgia. J Neurol Neurosurg Psychiatry. 1959 Feb;22(1):36–43. doi: 10.1136/jnnp.22.1.36. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Lazar M. L., Kirkpatrick J. B. Trigeminal neuralgia and multiple sclerosis: demonstration of the plaque in an operative case. Neurosurgery. 1979 Dec;5(6):711–717. doi: 10.1227/00006123-197912000-00013. [DOI] [PubMed] [Google Scholar]
  18. Linderoth B., Håkanson S. Paroxysmal facial pain in disseminated sclerosis treated by retrogasserian glycerol injection. Acta Neurol Scand. 1989 Oct;80(4):341–346. doi: 10.1111/j.1600-0404.1989.tb03890.x. [DOI] [PubMed] [Google Scholar]
  19. Meaney J. F., Miles J. B., Nixon T. E., Whitehouse G. H., Ballantyne E. S., Eldridge P. R. Vascular contact with the fifth cranial nerve at the pons in patients with trigeminal neuralgia: detection with 3D FISP imaging. AJR Am J Roentgenol. 1994 Dec;163(6):1447–1452. doi: 10.2214/ajr.163.6.7992745. [DOI] [PubMed] [Google Scholar]
  20. Olafson R. A., Rushton J. G., Sayre G. P. Trigeminal neuralgia in a patient with multiple sclerosis. An autopsy report. J Neurosurg. 1966 Apr;24(4):755–759. doi: 10.3171/jns.1966.24.4.0755. [DOI] [PubMed] [Google Scholar]
  21. Pollack I. F., Jannetta P. J., Bissonette D. J. Bilateral trigeminal neuralgia: a 14-year experience with microvascular decompression. J Neurosurg. 1988 Apr;68(4):559–565. doi: 10.3171/jns.1988.68.4.0559. [DOI] [PubMed] [Google Scholar]
  22. Poser C. M., Paty D. W., Scheinberg L., McDonald W. I., Davis F. A., Ebers G. C., Johnson K. P., Sibley W. A., Silberberg D. H., Tourtellotte W. W. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol. 1983 Mar;13(3):227–231. doi: 10.1002/ana.410130302. [DOI] [PubMed] [Google Scholar]
  23. Wallace C. J., Seland T. P., Fong T. C. Multiple sclerosis: the impact of MR imaging. AJR Am J Roentgenol. 1992 Apr;158(4):849–857. doi: 10.2214/ajr.158.4.1546605. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES