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Trigeminal neuralgia due to Dandy-Walker syndrome
Wenhao Zhang1, Minjie Chen, Weijie Zhang
1Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
The Journal of Craniofacial Surgery
|July 16, 2013
Summary
Dandy-Walker syndrome (DWS), a rare congenital brain malformation, can cause trigeminal neuralgia (TN), a common orofacial pain. This case highlights DWS as an unusual etiology for TN, emphasizing the need for comprehensive neurological evaluation.
Area of Science:
- Neurology
- Developmental Biology
- Neuroimaging
Background:
- Trigeminal neuralgia (TN) is characterized by orofacial pain.
- Dandy-Walker syndrome (DWS) is a rare congenital hindbrain malformation.
- The co-occurrence of DWS and TN is exceptionally uncommon.
Observation:
- A 36-year-old male presented with typical trigeminal neuralgia symptoms.
- Standard physical examination revealed no abnormalities.
- Enhanced magnetic resonance imaging (MRI) identified significant obstructive hydrocephalus, a large posterior fossa cyst, and cerebellar hypoplasia.
Findings:
- MRI revealed enlarged ventricles (lateral, third, and fourth) and a hypoplastic cerebellar vermis, consistent with DWS.
- The patient's trigeminal neuralgia pain was effectively managed with Tegretol (carbamazepine).
- The neuroimaging findings correlated with the clinical presentation of TN.
Implications:
- This case suggests Dandy-Walker syndrome as a potential, albeit rare, cause of trigeminal neuralgia.
- Highlights the importance of advanced neuroimaging in diagnosing atypical presentations of neurological disorders.
- Underscores the need to consider congenital malformations in the differential diagnosis of trigeminal neuralgia.
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