Magnetic resonance neurography in the management of peripheral trigeminal neuropathy: experience in a tertiary care centre

Brian Cox, John R Zuniga, Neeraj Panchal, Jonathan J Cheng, Avneesh Chhabra

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Objective: This tertiary care experience examines the utility of magnetic resonance neurography (MRN) in the management of peripheral trigeminal neuropathies. Materials and methods: Seventeen patients with clinically suspected peripheral trigeminal neuropathies (inferior alveolar nerve and lingual nerve) were imaged uniformly with 1.5-T examinations. MRN results were correlated with clinical and surgical findings in operated patients and the impact on clinical management was assessed. Results: Clinical findings included pain (14/17), sensory changes (15/17), motor changes (2/17) and palpable masses (3/17). Inciting events included prior dental surgery (12/17), trauma (1/17) and idiopathic incidents (4/17). Non-affected side nerves and trigeminal nerves in the intracranial and skull base course were normal in all cases. Final diagnoses on affected sides were nerve inflammation (4/17), neuroma in continuity (2/17), LN transection (1/17), scar entrapment (3/17), infectious granuloma (1/17), low-grade injuries (3/17) and no abnormality (3/17). Associated submandibular gland and sublingual gland oedema-like changes were seen in 3/17 cases because of parasympathetic effects. Moderate-to-excellent MRN-surgical correlation was seen in operated (8/17) patients, and neuroma and nerve transection were prospectively identified in all cases. Conclusion: MRN is useful for the diagnostic work-up of suspected peripheral trigeminal neuropathy patients with significant impact on clinical management and moderate-to-excellent correlation with intra-operative findings. Key Points: • MRN substantially impacts diagnostic thinking and management in peripheral trigeminal neuropathy.• MRN has moderate-to-excellent correlation with intra-operative findings.• MRN should be considered in pre-surgical planning of peripheral trigeminal neuropathy subjects.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalEuropean Radiology
DOIs
StateAccepted/In press - Jan 21 2016

Keywords

  • Inferior alveolar nerve
  • Lingual nerve
  • MRN
  • Neurography
  • Trigeminal nerve

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Magnetic resonance neurography in the management of peripheral trigeminal neuropathy: experience in a tertiary care centre'. Together they form a unique fingerprint.

  • Cite this