Skull Base 2010; 20(4): 293-299
DOI: 10.1055/s-0030-1249245
CASE REPORT

© Thieme Medical Publishers

Lipomatosis of the Trigeminal Nerve Causing Trigeminal Neuralgia: Case Report and Literature Review

Eleni Chryssa Maratos1 , Maria Terésa Goicochea2 , Santiago Condomí-Alcorta3 , Rubén Mormandi3 , Jorge Salvat3 , Andrés Cervio3
  • 1Department of Neurosurgery, The Royal London Hospital, Barts and the London NHS Trust, London, United Kingdom
  • 2Department of Neurology, FLENI Institute, Buenos Aires, Argentina
  • 3Department of Neurosurgery, FLENI Institute, Buenos Aires, Argentina
Further Information

Publication History

Publication Date:
01 March 2010 (online)

ABSTRACT

Cerebellopontine angle lipomas are rare and attempts at surgical excision are associated with significant morbidity. Lipomatosis of nerve, the fatty infiltration of nerves, is a distinct entity. We present a case of intractible trigeminal neuralgia caused by lipomatosis of the trigeminal nerve. Clinical case: A 25-year-old male presented with severe right-sided trigeminal neuralgia. Imaging showed a lesion involving the trigeminal nerve with signal characteristics of fat. At surgery the lesion was found to be a fatty infiltration of the nerve itself. Surgery was therefore limited to arachnoid adhesiolysis. The patient remains symptom-free and neurologically intact to date. Correctly identifying these lesions as lipomatosis of nerve rather than lipoma of the cerebellopontine angle make it clear that even partial surgical excision will inevitably result in neurological deficit and should not be attempted. However, in the case of intractable trigeminal neuralgia we demonstrate that surgery can still play a role.

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Dr. Andrés Cervio

Department of Neurosurgery, FLENI Institute

Montañeses 2325 (C1428AQK), Buenos Aires, Argentina

Email: acervio@fleni.org.ar