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Magnetic resonance neurography in the management of peripheral trigeminal neuropathy: experience in a tertiary care centre.

Abstract：

OBJECTIVE:This tertiary care experience examines the utility of magnetic resonance neurography (MRN) in the management of peripheral trigeminal neuropathies. MATERIALS AND METHODS:Seventeen patients with clinically suspected peripheral trigeminal neuropathies (inferior alveolar nerve and lingual nerve) were imaged uniformly with 1.5-T examinations. MRN results were correlated with clinical and surgical findings in operated patients and the impact on clinical management was assessed. RESULTS:Clinical findings included pain (14/17), sensory changes (15/17), motor changes (2/17) and palpable masses (3/17). Inciting events included prior dental surgery (12/17), trauma (1/17) and idiopathic incidents (4/17). Non-affected side nerves and trigeminal nerves in the intracranial and skull base course were normal in all cases. Final diagnoses on affected sides were nerve inflammation (4/17), neuroma in continuity (2/17), LN transection (1/17), scar entrapment (3/17), infectious granuloma (1/17), low-grade injuries (3/17) and no abnormality (3/17). Associated submandibular gland and sublingual gland oedema-like changes were seen in 3/17 cases because of parasympathetic effects. Moderate-to-excellent MRN-surgical correlation was seen in operated (8/17) patients, and neuroma and nerve transection were prospectively identified in all cases. CONCLUSION:MRN is useful for the diagnostic work-up of suspected peripheral trigeminal neuropathy patients with significant impact on clinical management and moderate-to-excellent correlation with intra-operative findings. KEY POINTS:• MRN substantially impacts diagnostic thinking and management in peripheral trigeminal neuropathy. • MRN has moderate-to-excellent correlation with intra-operative findings. • MRN should be considered in pre-surgical planning of peripheral trigeminal neuropathy subjects.

journal_name

Eur Radiol

journal_title

European radiology

authors

Cox B,Zuniga JR,Panchal N,Cheng J,Chhabra A

doi

10.1007/s00330-015-4182-5

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

3392-400

issue

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-015-4182-5

journal_volume

pub_type

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Magnetic resonance neurography in the management of peripheral trigeminal neuropathy: experience in a tertiary care centre.