International Journal of Clinical & Medical Images

A 68 year male subject presented with the complaint of recurrent episodes of unilateral, shock like pain in the right cheek and jaw region since 20days. His condition was worsened during shaving, drinking, chewing and also upon light touch to trigger zones(alae of the nose and corner of the lip). A thorough clinical examination revealed no evidence of pulpal, periodontal and tmj pathology. The patient had a significant reduction in pain following administration of 100mg carbemazepine(test dose) and local anesthetic nerve blocks. Based on the clinical findings and the test(test dose and nerve blocks) results a tentative diagnosis of trigeminal neuralgia was made following which he was subjected to radiographic examination. 3D-TOF-angiogram(Panel A) and 3D CISS-axial view(Panel B) demonstrated an aberrant vascular loop of the right superior cerebellar artery compressing the cisternal segment of the right trigeminal nerve(Denoted by orange arrows). The Treatment plan included a combination of Carbemazepine and gabapentin. He responded very well to these drugs and was free of symptoms even after an year of follow up. Trigeminal neuralgia is a facial neuralgia that is characterized by lancenating pain, caused by a focal demyelination of the sensory fibers in the trigeminal nerve

*Corresponding author: Prashanth Panta, Department of oral medicine and radiology, MNR Dental College and Hospital, Narsapurroad, Sangareddy (502294), Andhra Pradesh, India, Tel: 91-9701806830; E-Mail: maithreya.prashanth@gmail.com