Trigeminal Neuralgia as An Atypical Manifestation of Intracranial Hypertension. Case Report and Literature Review

Abstract

Trigeminal neuralgia, a chronic neuropathic pain, is characterized by frequent episodes of stabbing facial pain, in the territory of the trigeminal nerve, which can severely impair patient’s quality of life. It is primarily caused by vascular compression of the trigeminal nerve root, but it is sometimes secondary to other identifiable neurological conditions, such as multiple sclerosis or a cerebellopontine angle tumor. Uncommonly, it may be caused by the presence of idiopathic intracranial hypertension, a condition most likely identified by headache, visual disturbances, and sixth nerve palsy, among other manifestations. Secondary causes of trigeminal neuralgia are usually detected after an atypical clinical manifestation, such as ophthalmic rather than maxillary or mandibular nerve involvement, more than one branch affected, or bilateral symptoms. We present a patient who presented with trigeminal neuralgia as a primary manifestation, and after thorough evaluation she was diagnosed with intracranial hypertension as the underlying mechanism responsible of the trigeminal neuralgia.