Imaging

Trigeminal Neuralgia

Preliminary Diagnosis: Trigeminal neuralgia

I. What imaging technique is first-line for this diagnosis

  • Contrast MR of the brain according to trigeminal protocol with thin axial cuts

II. Describe the advantages and disadvantages of this technique for diagnosis of trigeminal neuralgia.

Advantages

  • Able to exquisitely detail the trigeminal nerves from the root entry zone distally through the face to look for any soft tissue or vascular pathology or any abnormal enhancement.

Disadvantages

  • Expensive

  • Time-consuming

  • Requires significant patient cooperation as the images are subject to motion artifact

  • May be limited in patients with non-MR compatible metallic hardware.

III. What are the contraindications for the first-line imaging technique?

  • MR imaging is contraindicated in patients with non-MR compatible hardware.

IV. What alternative imaging techniques are available?

  • No alternative imaging techniques exist

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of trigeminal neuralgia.

  • Not applicable

VI. What are the contraindications for the alternative imaging techniques?

  • Not applicable

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