Functional MRI of Patient with Trigeminal Neuralgia: A Case Report

Abstract

Background and Objective: Trigeminal neuralgia (TN) is a chronic pain condition that affects the trigeminal nerve causing severe intermittent sharp shooting pain the orofacial area. Nowadays, the best treatment has not been purposed because it depends on individual’s pain characteristic.

Method: A case report of 58 years old Thai female presented with tooth brushing and washing her face normally triggered the pain. Sensory test of the maxillary branch (V₂) of trigeminal nerve showed a sign of allodynia with the average pain severity measured by visual analog scale was 7. She was diagnosed with right classical trigeminal neuralgia.  She underwent brain fMRI to identify the cause of pain.

Results: The fMRI brain study was done with mechanical stimulation (brush) revealed that there were differences between pain and non-pain sides. The pain locations were active at anterior insular cortex and the Thalamus.

Conclusions : The beneficial of this study might offer the chance of understanding the mechanism of TN pain. An alternative diagnostic tool, functional Magnetic Resonance Imaging (fMRI) can help to diagnosis, to classify the reasons of pain and to study the effect of drug used in TN patient.