Bilateral trigeminal neuralgia associated with Chiari's type I malformation

Abstract

Trigeminal neuralgia in Chiari's type I malformation is rare and remains a therapeutic challenge. We report a case of bilateral trigeminal neuralgia in Chiari's type I malformation. This case demonstrates that microvascular decompression can be an effective treatment strategy for this complex pathology.

Trigeminal neuralgia associated with Chiari 1 malformation: symptom resolution following craniocervical decompression and duroplasty: Case report and review of the literature

“…Case reports describe a range of successful treatments in cases of TN associated with Chiari malformation including medical treatment with carbamazepine[ 7 ] and craniocervical decompression[ 3 10 12 ] as with this case. A bilateral TN case with associated CM was successfully treated with bilateral microvascular decompression (MVD),[ 15 ] however, it is argued by some authors that retrosigmoid craniotomy for MVD may improve symptoms by indirectly decompressing the foramen magnum. [ 6 ] Cases with associated hydrocephalus have been treated successfully with endoscopic third ventriculostomy[ 11 ] and ventricular shunt procedures.…”

Tratamiento quirúrgico de la neuralgia del trigémino en adultos

“…El 68%, a 4.27 años de seguimiento, tuvieron un BNI ≤2 y el 62% no reportan limitaciones en sus actividades laborales 17 . En casos de NT sintomática se han observado desenlaces inferiores particularmente en casos de esclerosis múltiple 18 ; en otras circunstancias mucho menos frecuentes, como la malformación de Chiari tipo I 19 o la enfermedad de Charcot-Marie-Tooth 20 , la DMV ha sido la opción que mejor ha resultado para el control del dolor. Aun en caso de persistencia o recurrencia de la NT tras una DMV, repetir la DMV puede ofrecer un buen desenlace; un hallazgo intraoperatorio negativo en la reintervención y la no mejoría tras la cirugía inicial son factores pronósticos de un desenlace desfavorable en esta circunstancia 21 .…”

Management of Uncommon Secondary Trigeminal neuralgia related to a rare Arnold Chiari type I malformation

“…14,15 A variety of treatment options are available for TN secondary to ACM that may include microvascular decompression (MVD), retro-sigmoid craniotomy, endoscopic third ventriculostomy and ventricular shunt procedures. [14][15][16][17][18] Craniocervical decompression has been reported with 73 per cent resolution of pain symptoms. 15 It could be interesting to approach future therapies by using of mesenchymal stem cells, given their paracrine immunoregulatory effects.…”