Paroxysmal Neuralgia in Pediatric Population- A Diagnostic Dilemma for Physicians and Dental Practioners

Mujoo, Sheetal; Sakarde, SB; Ak, Dutta

doi:10.3126/kumj.v10i4.11000

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…TN is rare below the age of 40, but it can affect the pediatric population, and cases have been reported even in patients as young as 1 year of age [ 15 - 18 ]. In 90% of the cases, symptoms begin after age 40, and incidence progressively increases with age, from 17.5/100 000/year between 60 and 69 years of age up to 25.6/100 000/year after age 70 [ 3 , 5 , 14 ].…”

Section: Epidemiologymentioning

confidence: 99%

Trigeminal Neuralgia: Basic and Clinical Aspects

et al. 2020

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The trigeminal nerve is the largest of all cranial nerves. It has three branches that provide the main sensory innervation of the anterior two-thirds of the head and face. Trigeminal neuralgia (TN) is characterized by sudden, severe, brief, and stabbing recurrent episodes of facial pain in one or more branches of the trigeminal nerve. Pain attacks can occur spontaneously or can be triggered by non-noxious stimuli, such as talking, eating, washing the face, brushing teeth, shaving, a light touch or even a cool breeze. In addition to pain attacks, a proportion of the patients also experience persistent background pain, which along with autonomic signs and prolonged disease duration, represent predictors of worse treatment outcomes. It is now widely accepted that the presence of a neurovascular compression at the trigeminal root entry zone is an anatomic abnormality with a high correlation with classical TN. However, TN may be related to other etiologies, thus presenting different and/or additional features. Since the 1960s, the anticonvulsant carbamazepine is the drug of choice for TN treatment. Although anti-epileptic drugs are commonly used to treat neuropathic pain in general, the efficacy of carbamazepine has been largely limited to TN. Carbamazepine, however, is associated with dose-limiting side-effects, particularly with prolonged usage. Thus, a better understanding and new treatment options are urgently warranted for this rare, but excruciating disease.

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Section: Epidemiologymentioning

confidence: 99%

Trigeminal Neuralgia: Basic and Clinical Aspects

et al. 2020

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“…It wasn't until 1779 that John Hunter first recognized the disease as a form of nervous disorder. 2 Present day descriptions of TN in adults have designated classic (TN1) and atypical (TN2) forms of the disorder.…”

Section: Chicoinementioning

confidence: 99%

Surgical Management of Trigeminal Neuralgia in Children

et al. 2019

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BACKGROUND Trigeminal Neuralgia (TN) is a well-recognized facial pain syndrome. Discrete forms with disparate pain symptoms include TN1 and TN2, however, atypical facial pain includes neuralgiform pain along a spectrum. The majority of TN is diagnosed in the adult population. Case reports and series in children present TN as a similar diagnosis which can be similarly treated as in adults. This manuscript reviews pertinent literature and presents two pediatric TN cases successfully treated with microvascular decompression (MVD). CASE DESCRIPTION Two pediatric patients (ages 12 and 15) were identified with TN that was refractory to previous medical therapy. The patients were both deemed appropriate surgical candidates and were treated with MVD to manage their TN. TN compression was arterial in both cases and involved portions of the anterior inferior cerebellar artery. Patient 1 was found to be pain-free 6 months following the procedure. Patient 2 was pain-free immediately following the procedure and has since been weaned off preoperative symptomatic management. The most recent follow-up is 12 and 8 months, respectively, with continued pain freedom. CONCLUSIONS There are few reports on the effectiveness of MVD in the pediatric population for the management of TN. Supporting literature, as well as the cases presented, demonstrate that MVD is an effective treatment for pediatric patients in managing their TN. Furthermore, there appears to be minimal side effects, with excellent pain relief with MVD in this patient population.

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