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Malpositioned endolymphatic subarachnoid shunt causing trigeminal neuralgia: case report
L G Leibrock1, G F Moore, M Yetter
1Department of Surgery (Neurosurgery), University of Nebraska Medical Center, Omaha.
Acta Neurochirurgica
|January 1, 1994
Summary
A migrated endolymphatic shunt caused severe trigeminal neuralgia in a patient. Surgical removal of the shunt resolved the facial pain, suggesting a potential new cause for this condition.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Trigeminal neuralgia (TN) is a chronic pain condition affecting the trigeminal nerve.
- Meniere's disease treatment can involve endolymphatic subarachnoid shunts.
Observation:
- A 64-year-old female with a 15-year history of right facial pain, diagnosed as trigeminal neuralgia, had a history of Meniere's disease treated with an endolymphatic subarachnoid shunt.
- Despite various treatments, her pain persisted until a retrosigmoid rhizotomy was performed.
Findings:
- Intraoperative findings revealed the endolymphatic subarachnoid shunt positioned near the trigeminal nerve roots.
- Removal of the shunt during surgery resulted in complete pain relief for the patient over 30 months.
Implications:
- This case suggests that a malpositioned or migrated endolymphatic subarachnoid shunt could be a novel cause of trigeminal neuralgia.
- Further investigation is warranted to explore the relationship between endolymphatic shunts and trigeminal nerve dysfunction.