Clinical Characteristics of Seven Cases of Pretrigeminal Neuralgia: A Case Series Study
Yoko Yamazaki, Maya Sakamoto, Hikari Tominaga, Wako Yamazaki, Aki Kawauchi, Shigeru MaedaABSTRACT
Aim
This study investigated clinical pain features suggestive of trigeminal neuralgia in pretrigeminal neuralgia.
Methods
This study included seven of 80 patients definitively diagnosed with trigeminal neuralgia at our orofacial pain clinic between January and December 2015, whose initial symptoms raised suspicion of pretrigeminal neuralgia. We extracted and analyzed the following data from anonymized medical records: sex, age, medical history, allergies, current medications, chief complaint, current medical history, current symptoms, diagnosis, magnetic resonance imaging (MRI) findings, culprit blood vessel or suspected tumor type, treatment methods, and clinical course.
Results
The patients included three men and four women. The right side was affected in six cases. Pain was described as a sensation of floating teeth, throbbing, dull, piercing, intense, or flickering pain. Pain lasted 1 h or longer in six cases and ranged from 1 s to 1 h in one case. Six patients received diagnoses other than trigeminal neuralgia. Microvascular decompression was performed in three cases, and pain resolved postoperatively in all three patients. Brain tumors were confirmed in two cases.
Conclusion
The findings suggest that, in pretrigeminal neuralgia, pain is often localized on the right side, has a fixed location, and is associated with triggering factors. However, these features cannot be considered decisive. Because trigeminal neuralgia is difficult to diagnose during the pretrigeminal neuralgia phase, long‐term follow‐up is essential after a diagnosis of idiopathic orofacial pain. Furthermore, if symptoms characteristic of trigeminal neuralgia develop during follow‐up, head MRI should be performed to rule out a brain tumor.