Trigeminal Neuralgia and Cerebellopontine‐Angle Lipoma in a Child

Abstract

Trigeminal neuralgia and cerebellopontine-angle lipomas are very rare in children. We describe the history and findings of an 8-year-old boy with right trigeminal neuralgia and a lipoma detected by magnetic resonance imaging at the level of the root-entry zone of the right seventh cranial nerve. We propose a possible mechanism of infiltration of the trigeminal rootlets by the lipoma.

Paroxysmal Neuralgia in Pediatric Population- A Diagnostic Dilemma for Physicians and Dental Practioners

“…20 Trigeminal neuralgia has also been associated with lipomas in children. 21 Glossopharyngeal neuralgia arises due to various causes such as tumor , infection , Chiari I malformation, infarction, dissection of the vertebral artery or neurovascular compression. 22 Childs et al have reported a case of GN in a 13 year old girl which was caused due to looping of the posterior inferior cerebellar artery.…”

“…25 Raieli et al administered carbamazepine (15 mg/ kg/day) to an 8-yearold patient suffering from trigeminal neuralgia with good results. 21 A case of trigeminal neuralgia in a 12-year-old female was controlled using gabapentin (1,200 mg/day) in combination with carbamazepine (800 mg/day). 7 Besides anticonvulsants, high dose courses of amitriptyline, phenytoin, baclofen, sodium valproate, sumatriptan, and acyclovir, together with a three day course of methylprednisolone have also been tried.…”

Trigeminal Neuralgia Associated with Cerebellopontine Angle Lipoma in Childhood

“…Trigeminal neuralgia (TGN) is extremely rare in paediatric populations in comparison with older ages [1,2]. Venous compression is usually the main cause of paediatric TGN.…”

“…Venous compression is usually the main cause of paediatric TGN. Additionally neoplasms or benign mass lesions in the cerebellopontine angle (CPA) may lead to TGN [1]. Carbamazepine is the first-choice medical treatment but it may not provide durable pain relief [2].…”

“…In symptomatic cases lipomas of the CPA can cause vertigo, dizziness, tinnitus, and loss of hearing [3,4,8]. To our knowledge, 3 cases of TGN associated with CPA lipoma in childhood have been reported (table 1) [1,9,10]. Surgical treatment is difficult because of strong adhesion to surrounding tissues [5,6].…”