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

Abstract

Trigeminal neuralgia (TN) is a paroxysmal shock-like pain restricted to the innervations of the areas of one or more trigeminal branches, often set off by light stimuli in a trigger zone. Pain attacks occur spontaneously, and can also be triggered by a nonpainful sensory stimulus to the skin, intraoral mucosa surrounding the teeth, or tongue. The pathogenesis of TN is uncertain and typically is idiopathic, but it may be due to a structural lesion. Various proposed causes include traumatic compression of the trigeminal nerve by neoplastic or vascular anomalies, infectious agents such as human herpes simplex virus, and intracranial tumors or demyelinating conditions such as multiple sclerosis. Here we report a case of a young patient diagnosed with trigeminal neuralgia secondary to epidermoid cyst at the cerebellopontine angle.

Diagnostic Importance of Flair and Diffusion Weighted Magnetic Resonance Imaging of the Atypic Intracranial Epidermoid Cysts

“…In some cases, expansile overgrowth may cause rupture, and the leakage of cyst contents produces chemical irritation of the leptomeninges or ependyma (7). Most of the symptoms mainly depend on the location and the mass effect of the lesion rather than the natural course of the disease (8).…”

Epidermoid cyst of the posterior fossa: a case report

“…The lesions tend to surround and envelope, rather than displace, regional structures. The leakage of cyst contents produces chemical irritation of the leptomeninges or ependyma (1,4,9,10,14) .…”

Trigeminal neuralgia as the initial manifestation of temporal glioma: Report of three cases and a review of the literature

“…[4614] The focal compression of the trigeminal nerve root, by an aberrant loop of an artery or vein at the root entry zone (REZ), has been the most acceptable theory for the development of idiopathic TN. [12459] There are also other etiologies mentioned for TN including, infiltration of the nerve root, Gasserian ganglion or branches by a tumor or amyloidoma,[1391112] small infarcts, angioma or cavernoma in the pons, medulla, or REZ,[12716] chemical irritation by neoplastic factors,[2111214] herniation of the temporal lobe,[2] chronic subdural hematoma, hydrocephalous[4] posterior fossa tumors,[5–814] contralateral posterior fossa tumors,[58] ipsilateral and contralateral supra tentorial tumors,[468912] basilar invagination,[8] and Chiari malformation. [10]…”

“…[267] The exact etiology of primary TN is unknown, although vascular compression is often accepted as the origin of the pain,[1718] but symptomatic TN is said to have a manifest cause, such as tumor, amyloidoma, infarct, or multiple sclerosis (MS). [1–791112141619] Temporal glioma is a rare cause of TN, and our wide search of the literature using relevant key words and hand search of all the references could find only three similar cases reported previously. [912] It is intended to report three cases of temporal glioma of different grades presenting with TN and we will try to explain different mechanisms possibly involved in this relationship.…”

“…[1–791112141619] Temporal glioma is a rare cause of TN, and our wide search of the literature using relevant key words and hand search of all the references could find only three similar cases reported previously. [912] It is intended to report three cases of temporal glioma of different grades presenting with TN and we will try to explain different mechanisms possibly involved in this relationship.…”