Trigeminal neuralgia due to pontine infarction

Abstract

Abstract-Objective: To examine the relationship between early clinical features, pathologies, and biochemistry of the frontotemporal lobar degenerations (FTLDs), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD). Methods: The authors conducted pathologic reexamination with the most recent immunohistochemistry of all cases diagnosed with FTLD, PSP, and CBD between 1970 and. The authors also reviewed the early clinical features for clinical diagnosis and application of published research criteria. Results: Of 127 cases analyzed, 57 had a pathologic diagnosis of FTLD, 49 PSP, and 21 CBD. Of these, 38 were clinically reclassified as frontal variant frontotemporal dementia (FTD), 13 as progressive non-fluent aphasia (PNFA), 21 as CBD-like, 33 as PSP-like, and 13 with frontotemporal dementia with coexisting motor neuron disease (FTD-MND). The authors were unable to classify nine cases. All cases of FTD-MND were tau-negative and had pathologic evidence of motor neuron degeneration. All cases classified as PSP-like or CBD-like had tau-positive pathology. Of the 13 cases with PNFA, PSP and CBD accounted for almost 70% of the cases, while FTD was almost equally divided between tau-positive and tau-negative diseases. Conclusion: Frontotemporal lobar degeneration, corticobasal degeneration (CBD), and progressive supranuclear palsy (PSP) have overlapping clinical features. The prediction of tau-positive pathology from a CBD or PSP-like presentation is good, while the frontotemporal dementia (FTD)-motor neuron disease syndrome almost certainly predicts motor neuron degeneration. Surprisingly, PSP and CBD accounted for most cases classified as progressive non-fluent aphasia. Frontal variant FTD is an unpredictable disease in terms of its biochemistry.

Radiofrequency thermocoagulation for the treatment of trigeminal neuralgia associated with a focal pontine lesion: illustrative case

“…8 There are some more isolated case reports of TN developing after ischemic pontine lesions. [9][10][11][12][13][14] Others have pointed to an association of pontine lesions with TN but have not associated them with brain infarction. Arrese et al 15 reviewed 68 cases of non-MS-TN and found that four of them showed hyperintense lesions in the dorsolateral pons on T2weighted MRI sequences.…”

Outcomes of Gamma Knife surgery for trigeminal neuralgia secondary to vertebrobasilar ectasia

“…Less commonly, regional draining veins of the pons or cerebellum (6%-13%) may cause TN. 2,19,30 Other rare causes include primary demyelinating disorders, 4,36 infarcts of the brainstem, 13,27 tumors, and other masses of the posterior fossa. 1,17 Vertebrobasilar Ectasia as a Cause of TN Vertebrobasilar ectasia refers to pathological enlargement and distortion of the vertebrobasilar arterial system.…”