Advertisement

Trigeminal Neuralgia and Facial Pain Imaging

  • Steven Graff-RadfordEmail author
  • Rachael Gordon
  • John Ganal
  • Sotirois Tetradis
Imaging (L Mechtler, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Imaging

Abstract

The trigeminal nerve or fifth cranial nerve has an extensive distribution in the head and face. It is the source for pain conduction and thereby is often implicated in a variety of disorders including inflammatory and neoplastic diseases. To determine the disease source, understanding the trigeminal nerve anatomy is essential, and further being able to image the trigeminal nerve provides insight into the location and type of pathology. The best approach to imaging is to consider the nerve in segments. The nerve segments may be divided into the brainstem, cisternal, Meckel’s cave, cavernous sinus, and peripheral divisions. This review utilizes these segments to explore imaging options to help understand trigeminal neuralgia and pain in the trigeminal nerve distribution.

Keywords

Trigeminal neuralgia Trigeminal neuropathy Imaging MRI Radiograph 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Steven Graff-Radford, Rachael Gordon, John Ganal, and Sotirois Tetradis each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as • Of importance

  1. 1.
    Classification Committee of the International Headache Society. The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013;33:629–808.Google Scholar
  2. 2.•
    Bathla G, Hegde AN. The trigeminal nerve: an illustrated review of its imaging anatomy and pathology. Clin Radiol. 2013;68:203–13. This is an excellent review of the trigeminal nerve and it’s anatomy as seen with imaging.PubMedCrossRefGoogle Scholar
  3. 3.
    Joo W, Yoshioka F, Funaki T, Mizokami K, Rhoton Jr AL. Microsurgical anatomy of the trigeminal nerve. Clin Anat. 2014;27(1):61–88.PubMedCrossRefGoogle Scholar
  4. 4.
    Love S, Coakham HB. Trigeminal neuralgia. Pathology and pathogenesis. Brain. 2001;124:2347–60.PubMedCrossRefGoogle Scholar
  5. 5.
    Dandy W. Concerning the cause of trigeminal neuralgia. Am J Surg. 1934;24:477.CrossRefGoogle Scholar
  6. 6.
    McLaughlin MR, Janetta PJ, Clyde BL, Subach BR, Comey CH, Resnik DK. Microvascular decompression of cranial nerves: lessons learned after, 4400 operations. J Neurosurg. 1999;90(1):1–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Benoliel R, Zadik Y, Eliav E, Sharav Y. Peripheral painful traumatic trigeminal neuropathy: clinical features in 91 cases and proposal of novel diagnostic criteria. J Orofac Pain. 2012;26:49–58.PubMedGoogle Scholar
  8. 8.
    Borges A, Casselman J. Imaging the trigeminal nerve. Eur J Radiol. 2010;74:323–40.PubMedCrossRefGoogle Scholar
  9. 9.
    Kuroiwa T, Matsumoto S, Kato A, et al. MR imaging of idiopathic trigeminal neuralgia: correlation with non-surgical therapy. Radiat Med. 1996;14:235–9.PubMedGoogle Scholar
  10. 10.
    Fukuda H, Ishikawa M, Okumura R. Demonstration of neurovascular compression in trigeminal neuralgia and hemifacial spasm with magnetic resonance imaging: comparison with surgical findings in, 60 consecutive cases. Surg Neurol. 2003;59(2):93–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Campbell RL, Parks KW, Dodds RN. Chronic facial pain associated with endodontic therapy. Oral Surg Oral Med Oral Pathol. 1990;69(3):287–90. Google Scholar
  12. 12.
    Ardekian L, Dodson TB. Complications associated with the placement of dental implants. Oral Maxillofac Surg Clin N Am. 2003;15:243–9.CrossRefGoogle Scholar
  13. 13.
    Cruccu G, Biasiotta A, Di RS, et al. Trigeminal neuralgia and pain related to multiple sclerosis. Pain. 2009;143:186–91.PubMedCrossRefGoogle Scholar
  14. 14.
    Go JL, Kim PE, Zee C-S. The trigeminal nerve. Semin Ultrasound CT MRI. 2001;22(6):502–20.CrossRefGoogle Scholar
  15. 15.
    Graff-Radford SB, Ketalar M-C, Gratt BM, Solberg WK. Thermographic assessment of Neuropathic facial pain: a pilot study. J Orofacial Pain. 1995;9:138–46. Google Scholar
  16. 16.
    Tetradis S, Anstey P, Graff-Radford S. Cone beam tomography in the diagnosis of dental disease. CDA J. 2010;38:27–32.Google Scholar
  17. 17.•
    Borsook D, DaSilva AFM, Ploghaus A, Becarra L. Specific and somtotopic functional magnetic resonance imaging activation in the trigeminal ganglion by brush and noxious heat. J Neurosci. 2003;23(21):7897–903. This is a very important addition to the literature as it is the first study to define that the trigeminal nerve can be very accurately assessed with fMRI. This technique is likely to change our understanding of pain and how it is propogated in the nervous system.PubMedGoogle Scholar
  18. 18.
    Gizewski ER, Maderwald S, Linn J, Dassinger B, Bochmann K, Forsting M, et al. High-resolution anatomy of the human brain stem using 7-T MRI: improved detection of inner structures and nerves? Neuroradiology. 2014;56:177–86.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Steven Graff-Radford
    • 1
    Email author
  • Rachael Gordon
    • 2
  • John Ganal
    • 1
  • Sotirois Tetradis
    • 3
  1. 1.The Pain CenterCedars-Sinai Medical CenterLos AngelesUSA
  2. 2.Mink RadiologyBeverly HillsUSA
  3. 3.Oral and Maxillofacial RadiologyUCLA School of DentistryLos AngelesUSA

Personalised recommendations