Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Hardik Patel, M.D. Luke Rusowicz-Orazem, B.S.
Overview
Common causes of trigeminal neuralgia include sources of nerve compression from cardiovascular obstruction, tumor pressure, infectious disease , and facial trauma .
Classification
According to International Headache Society(IHS), in the International Classification of Headache Disorders, Third Edition (ICHD-3),TN is divided into classic (or classical) TN, secondary TN, and idiopathic TN.
Classic trigeminal neuralgia:
Trigeminal neuralgia developing without apparent cause other than neurovascular compression. MRI can demonstrate nerve root atrophy and/or displacement due to neurovascular compression as shown in image .
Common Causes
Causes by Organ System
Cardiovascular
Abnormal vessels , Arterial compression , Arteriovenous malformation , Ischemic cerebrovascular disorders , Stroke , Vascular anomalies , Vascular compression , Vascular malformation
Chemical/Poisoning
No underlying causes
Dental
No underlying causes
Dermatologic
Epidermoid , Scleroderma
Drug Side Effect
No underlying causes
Ear Nose Throat
Glossopharyngeal neuralgia , Oral surgery , Sinus surgery , Temporomadibular joint syndrome
Endocrine
No underlying causes
Environmental
No underlying causes
Gastroenterologic
No underlying causes
Genetic
No underlying causes
Hematologic
Aneurysms , Blood vessels compressing the trigeminal nerve root , Saccular aneurysm
Iatrogenic
Sinus surgery
Infectious Disease
Chronic meningeal inflammation , Chronic meningeal infection , Dental infection , Lyme disease , Postherpetic neuralgia
Musculoskeletal/Orthopedic
Facial spasm , Temporomadibular joint syndrome
Neurologic
Acoustic neuroma , Blood vessels compressing the trigeminal nerve root , Brain tumor , Chronic meningeal inflammation , Chronic meningeal infection , Cluster headache , Epidermoid , Facial spasm , Glossopharyngeal neuralgia , Ischemic cerebrovascular disorders , Meningioma , Multiple sclerosis , Pain syndrome , Physical damage to the nerve , Postherpetic neuralgia , Saccular aneurysm , Vascular anomalies , Vascular compression , Vestibular schwannoma
Nutritional/Metabolic
No underlying causes
Obstetric/Gynecologic
No underlying causes
Oncologic
Brain tumor , Meningioma , Tumors , Vestibular schwannoma
Ophthalmologic
No underlying causes
Overdose/Toxicity
No underlying causes
Psychiatric
No underlying causes
Pulmonary
Sarcoidosis
Renal/Electrolyte
No underlying causes
Rheumatology/Immunology/Allergy
Sarcoidosis , Systemic lupus erythematosus
Sexual
No underlying causes
Trauma
Facial trauma , Physical damage to the nerve
Urologic
No underlying causes
Miscellaneous
Aging , Idiopathic
Causes in Alphabetical Order
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References
↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
3D constructive interference in steady state MRI shows axial sections at the level of trigeminal nerve root entry into the pons. (A) Bilateral neurovascular contact without morphologic changes of the root in a patient with left trigeminal neuralgia (TN). Nerve (long arrows) and blood vessel (short arrows) appear hypointense surrounded by hyperintense CSF. Contact is seen at the root entry zone as well as mid-cisternal segment. (B, C) Morphologic changes exceeding mere neurovascular contact of the trigeminal nerve root are compatible with the diagnosis of classical TN. (B) Root atrophy in a patient with right TN. (C) Indentation and dislocation of the root in a patient with right TN (short arrow).
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