Bilateral trigeminal enhancement on magnetic resonance imaging in a patient with multiple sclerosis and trigeminal neuralgia

Abstract

We report on clinical and instrumental findings of a multiple sclerosis (MS) patient with sudden right trigeminal neuralgia (TN). Magnetic resonance imaging (MRI), performed at TN onset, showed enlargement of both trigeminal nerves (TrN) at the root entry zone, with gadolinium enhancement of the cisternal portion. This is the first description of clinical and MRI findings indicative of peripheral involvement of the fifth cranial nerve in a MS patient complaining of TN. Our report shows the concomitant involvement of central and peripheral myelin in MS, and adds further highlights to the question regarding peripheral nerve involvement abnormalities associated with a disease considered limited to the central nervous system (CNS). Multiple Sclerosis 2007; 13: 814-816. http://msj.sagepub.com

Keywords

magnetic resonance imaging multiple sclerosis trigeminal enhancement trigeminal neuralgia

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References

Gass A. , Kitchen N. , MacManus DG , Moseley IF , Hennerici MG , Miller DH et al. Trigeminal neuralgia in patients with multiple sclerosis: lesion location with magnetic resonance imaging . Neurology 1997; 49: 1142-44 .

Meaney JF , Watt JW , Eldridge Jwg , Whitehouse GH , Wells Jcd , Miles JB Association between trigeminal neuralgia and multiple sclerosis: role ofl magnetic resonance imaging . J Neurol Neurosurg Psychiatry 1995; 59(3): 253-59 .

van der Meijs , Tan, IL , Barkhof F. Incidence ofl enhancement ofl the trigeminal nerve on MRI in patients with multiple sclerosis . Mult Scler 2002; 8: 64-67 .

da Silva CJ , da Rocha AJ , Mendes MF , Maia AcmJr , Braga FT , Tilbey CP Trigeminal involvement in multiple sclerosis: magnetic resonance imaging findings with clinical correlation in a series ofl patients . Mult Scler 2005; 11: 282-85 .

Bergamaschi R. , Romani A. , Zappoli F. , Versino M. , Cosi V. MRI and brainstem auditory evoked potential evidence in eight cranial nerve involvement in multiple sclerosis . Neurology 1997; 48: 270-72 .

Brinkemeier H. , Aulkmeyer P. , Wollinsky KH , Rudel R. An endogenous pentapeptide acting as a sodium channel blocker in inflammatory autoimmune disorders ofl the central nervous system . Nat Med 2000; 6(7): 80811 .

Couratier P. , Boukris S. , Magy L. , Traorè H. , Vallat JM Sclérose en plaques et atteinte du système nerveux périphérique . Rev Neurol ( Paris ) 2004; 160: 12, 115963 .