The importance of routine magnetic resonance imaging in trigeminal neuralgia diagnosis

Accommodation to Diagnosis of Trigeminal Neuralgia

“…Neuroimaging with head computed tomography (CT) or magnetic resonance imaging (MRI) may be useful for identifying patients that have a structural lesion as the cause of painful trigeminal neuropathy 19,20 . High-resolution brain MRI and magnetic resonance angiography (MRA) may be useful to identify vascular compression as the etiology of classic TN.…”

Practice Parameter: The diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review)

“…Five articles (one graded Class IV) reported the results of head imaging on consecutive patients diagnosed with TN with normal neurologic examinations (table e-1). [4][5][6][7][8] Four studies included cohorts of patients with TN assembled at tertiary centers with an interest in TN. Because more complicated and potentially less representative patients with TN get treated at such centers, these studies were judged to be at risk for referral bias and thus were graded Class III.…”

“…We found seven papers (one graded Class IV) studying the diagnostic accuracy of clinical characteristics potentially distinguishing STN from CTN (table e-2). [4][5][6][8][9][10][11] Clinical characteristics studied included the presence of sensory deficits, age at onset, first division of trigeminal nerve affected, bilateral trigeminal involvement, and unresponsiveness to treatment. One study was graded Class III because of a case control design with a narrow spectrum of patients.…”

“…However, these studies collected data retrospectively and were thus graded Class II. 5,6,8,10 We found one prospective Class I study. 4 In these studies, involvement of the first trigeminal division and unresponsiveness to treatment were not associated with a significant increase in the risk of STN.…”

Trigeminal neuralgia secondary to epidermoid cyst at the cerebellopontine angle: case report and brief overview

“…4 Selective indications for imaging, specifi cally magnetic resonance imaging (MRI), for patients with TN include young patients, patients failing to respond to medical therapy, those with an atypical history or clinical signs such as involvement of more than one division of the trigeminal nerve, bilateral involvement, and the presence of other cranial nerve abnormalities. 7 TN type pain was the only presenting feature in this case. There was no facial weakness or hearing loss, and the patient was younger than usual to be experiencing a classic TN.…”