Mandibular Myalgia and Miniscule Meckel’s Caves

Abstract

Trigeminal neuropathy manifests as episodic sharp, shooting pain in the maxillofacial region. Contributory etiologies are myriad, ranging from central pathology affecting its origin in the brainstem to peripheral processes affecting their distal-most insertion sites. We present a case of bilateral hypoplastic Meckel’s caves in an adult patient leading to the clinical symptomology of trigeminal neuralgia. To the best of our knowledge, this is the only report of its kind highlighting this anatomic variant.

Absent Meckel's cave as a possible cause of trigeminal neuralgia: A case report

“…An absent Meckel's cave as a possible cause of TN is a rarely described and poorly understood entity. Such a phenomenon has been described in only 2 case series, 7 patients and 3 patients, respectively, and 2 case reports, adding up to a total of 12 cases [10] , [11] , [12] , [13] . Interestingly, all cases reported in the literature, including ours, were female.…”

Absence of Meckel's Cave with Trigeminal Neuralgia: A Case Report

“…2 There are only a handful of reported cases in the literature of patients with absent Meckel's cave presenting with TN. 1,2,7,8 . All reported patients were females with an age range from 35 to 80 years, with a mean of 44.6 years and a median of 41.5 years.…”

Absence of Meckel Cave: A Rare Cause of Trigeminal Neuralgia

“…A few reported cases of this entity have been shown in patients with TN, including 1 case report and a series of 3 cases. [4][5][6] Our case series presents 7 patients with absence of a Meckel cave, in which all subjects had atrophy of the ipsilateral trigeminal nerve and ipsilateral TN. No patients with an absent Meckel cave were asymptomatic.…”

“…Before our series, few reported cases of an absent Meckel cave have been associated with ipsilateral TN without any prior surgical intervention on the cave. [4][5][6] A hypoplastic or absent Meckel cave has been occasionally described in the setting of congenital hypoplasia or aplasia of the trigeminal nerve; however, these cases have some key differences from our patients. 9,10 In contrast to our cohort, patients in these prior reports had symptoms that typically presented in early life and manifested as trigeminal neuropathy rather than neuralgia-commonly anesthesia in the trigeminal distribution and resulting neurotrophic keratitis.…”

“…3 Depending on the suspected etiology, various treatment options may be used, including medication, neurovascular decompression, stereotactic radiosurgery, or percutaneous balloon compression.A rarely reported entity, absence of Meckel cave, has been described in a few patients with TN, including 2 case reports and 3 patient case series. [4][5][6] Most important, there are only a few reports, to our knowledge, on the absence of Meckel cave in patients other than those with TN. This retrospective study aimed to demonstrate the potential relationship of an absent Meckel cave with TN versus without TN, which may have important diagnostic and treatment implications.…”