Basilar artery dolichoectasia an unusual and rare cause of secondary trigeminal neuralgia: a clinical report

Authors

DOI:

https://doi.org/10.14295/bds.2021.v24i1.2273

Abstract

Objective: Patients with Trigeminal Neuralgia often consults a dentist for relief of their symptoms as the pain seems to be arising from teeth and allied oral structures. Basilar artery Dolichoectasia is an unusual and very rare cause of secondary Trigeminal Neuralgia as it compresses the Trigeminal nerve Root Entry Zone. Case reports: We report three cases of Trigeminal Neuralgia caused by Basilar artery Dolichoectasia compression. The corneal reflex was found absent in all three of the cases along with mild neurological deficits in one case. Multiplanar T1/T2W images through the brain disclosed an aberrant, cirsoid (S-shaped) and torturous Dolichoectasia of basilar artery offending the Trigeminal nerve Root Entry Zone. Discussion: Based on these findings we propose a protocol for general dentist for diagnosis of patients with trigeminal neuralgia and timely exclusion of secondary intracranial causes. Conclusion: General dentists and oral surgeons ought to consider this diagnosis in patients presenting with chronic facial pain especially pain mimicking neuralgia with loss of corneal reflex or other neurosensory deficit on the face along with nighttime pain episodes. Timely and accurate diagnosis and prompt referral to a concerned specialist can have an enormous impact on patient survival rate in such cases.

KEYWORDS

Basilar artery; Cirsoid dolichoectasia; Corneal reflex; Trigeminal neuralgia.

Author Biographies

Zafar Ali Khan Ali Khan, College of Dentistry, Jouf University, Sakakah Al-Jawf 2014, Kingdom of Saudi Arabia.

Assistant Professor, Department Oral & Maxillofacial Surgery

Shammas Raza Khan Raza Khan, King Salman Specialist hospital, Hail 55471, Kingdom of Saudi Arabia.

Specialist Oral and Maxillofacial Surgeon

Tariq Mehmood, District Health Quarter Hospital Abbottabad. Pakistan.

District Specialist, Oral surgery department

Chaudhary Umar Asghar, Frontier Medical and Dental College, Abbottabad 22010, Pakistan.

House officer Dental out patient department

Naseer Ahmed, Altamash Institute of Dental Medicine

Associate Professor and head  department of Prosthodontics

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Published

2020-12-22

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Case Report or Clinical Technique