"A trigeminal neuralgia protocol should include a variety of sequences (FLAIR, T2, T1 pre- and post-contrast, DWI/ADC) which will depend on local preference and patient demographics. However, an evidence-based review found no evidence to support or refute the usefulness of MRI for this purpose 5."
"trigeminal neuropathy, e.g. post-herpetic, traumatic"
"Multiple sclerosis may also cause trigeminal neuralgia and, indeed, its incidence is much higher in multiple sclerosis patients than in the general population. It is thought that both pontine plaques and neurovascular compression in combination produce a "double-crush" mechanism whereby intra-pontine inflammatory demyelination and cisternal mechanical demyelination affect the same first-order neurones 20. Of interest, high T2/FLAIR signal of the intrapontine segment of the trigeminal nerve is encountered in approximately 5% of cases, often symmetrically 23,29. The aetiology of this is unclear as is whether this finding increases the likelihood of trigeminal neuralgia 23."
"Sequences"
"Grading"
"Location"
"On modern scanners, the primary sequence used to assess the anatomy of the cisternal portion of the trigeminal nerves and adjacent vessels is a high-resolution heavily T2-weighted sequence with minimal CSF flow artifact (e.g. CISS, FIESTA, SPACE) 22. This is usually supplemented with time-of-flight MR angiography, which allows co-registration of cisternal arteries with vessels seen on T2 imaging 22. See trigeminal neuralgia protocol."
"trigeminal nerve stimulator: considered "off-label" use (2025) in the USA 9"
"Gamma Knife radiosurgery focused at the trigeminal root in the posterior fossa"
"John Fothergill (1712-1780), an English physician, described a series of 14 cases of trigeminal neuralgia in a 1773 paper, hence the well-known eponym 14,15,17. Although, it is now thought that the condition had been described in the 2nd century by both the legendary Greek physician Galen (c.129-200) 18 and Aretaeus of Cappadocia 19, and also by Avicenna in the 11th century 14,15."
Expected headings
"Classical trigeminal neuralgia"
"Secondary trigeminal neuralgia"
"Assessing neurovascular compression"
"Assessing other causes"
"pain is electric shock-like, shooting, stabbing or sharp in quality"
"associated sensory changes, deafness or other ear problems"
"The initial treatment of trigeminal neuralgia is medical, with drugs such as carbamazepine, oxcarbazepine, lamotrigine, gabapentin, pregabalin or baclofen 21. Subcutaneous facial botulinum toxin therapy may also be efficacious 21."
"The pain in trigeminal neuralgia most often involves the maxillary division (V2) of the trigeminal nerve. The vast majority of cases are unilateral, with the right side of the face more commonly affected (1.5:1); around 3% are bilateral."
"MRI with high-resolution T2-weighted imaging is the imaging modality of choice 3. CT is limited in evaluating the brainstem and cisterns; however, if MRI is contraindicated, a CT cisternogram can outline the trigeminal nerves and cisternal vessels."
"As imaging has improved, the definition of contact has changed, and a variety of terms are used, including compression, contact, distortion, deformation, etc. 22."
"suspect if autonomic symptoms are prominent (e.g. lacrimation)"
"co-register MRA and thin T2 (e.g. CISS)"