A Alshukry1, F Salburgo1, L Jaloux1, J-P Lavieille2, M Montava3. 1. Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, AP-HM, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France. 2. Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, AP-HM, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France; IFSSTAR, LBA, UMR-T 24, Aix Marseille université, 13344 Marseille, France. 3. Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, AP-HM, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France; IFSSTAR, LBA, UMR-T 24, Aix Marseille université, 13344 Marseille, France. Electronic address: marion.montava@ap-hm.fr.
Abstract
OBJECTIVE: The primary objective of this review is to explore the different aspects of the diagnosis and management of Trigeminal neuralgia (TN). We look at the role of radiological imaging in the work-up of this condition, and based on the findings in the literature, we report data on the medical and surgical management of TN. MATERIALS AND METHODS: A literature review was conducted using PubMed and Cochrane search engines in order to explore the data available on the diagnosis and management of TN. Clinical features and various treatment modalities were analyzed by the authors. The identified studies were evaluated and data was reported on the different aspects of the condition in order to provide an evidence-based update on the topic. DISCUSSION: The diagnosis of TN is based on the patient's clinical history and radiological imaging. The commonest cause of TN is a micro-vascular compression by a looping blood vessel. Radiological evaluation is critical in the work-up of the disorder and in order to eliminate other possible causes. Management of the disorder can be medical or surgical, with micro-vascular decompression having the highest remission rate. CONCLUSION: Patients with TN present paroxysmal pain attacks in the territories innervated by the trigeminal nerve. Diagnostic investigations must allow precise anatomical evaluation of the CPA, and MR imaging is the gold-standard radiological investigation for this purpose. Management of TN can be medical or surgical, with micro-vascular decompression having the highest success rate.
OBJECTIVE: The primary objective of this review is to explore the different aspects of the diagnosis and management of Trigeminal neuralgia (TN). We look at the role of radiological imaging in the work-up of this condition, and based on the findings in the literature, we report data on the medical and surgical management of TN. MATERIALS AND METHODS: A literature review was conducted using PubMed and Cochrane search engines in order to explore the data available on the diagnosis and management of TN. Clinical features and various treatment modalities were analyzed by the authors. The identified studies were evaluated and data was reported on the different aspects of the condition in order to provide an evidence-based update on the topic. DISCUSSION: The diagnosis of TN is based on the patient's clinical history and radiological imaging. The commonest cause of TN is a micro-vascular compression by a looping blood vessel. Radiological evaluation is critical in the work-up of the disorder and in order to eliminate other possible causes. Management of the disorder can be medical or surgical, with micro-vascular decompression having the highest remission rate. CONCLUSION:Patients with TN present paroxysmal pain attacks in the territories innervated by the trigeminal nerve. Diagnostic investigations must allow precise anatomical evaluation of the CPA, and MR imaging is the gold-standard radiological investigation for this purpose. Management of TN can be medical or surgical, with micro-vascular decompression having the highest success rate.
Authors: Nucelio Lemos; Laura Cancelliere; Adrienne L K Li; Renato Moretti Marques; Gustavo L Fernandes; Corey Sermer; Kinshuk Kumar; Jose Sebastião Afonso; Manoel J B C Girão Journal: J Hip Preserv Surg Date: 2019-03-25