ASSOCIATION BETWEEN TRIGEMINAL NEURALGIA AND MULTIPLE-SCLEROSIS - ROLE OF MAGNETIC-RESONANCE-IMAGING

Seven consecutive patients with multiple sclerosis and trigeminal neur algia were investigated with MRI to determine the occurrence of a lesi on which would account for the patients' pain. Two patients had bilate ral symptoms. In the patients with unilateral trigeminal neuralgia vas cular compression of the nerve by an artery at the root entry zone on the symptomatic side was confirmed in three patients and an epidermoid tumour distorting the nerve on the symptomatic side was identified in one patient. A demyelinating plaque was identified in only one patien t, affecting the trigeminal nerve at the root entry zone at the pens. In those with bilateral symptoms neurovascular compression was identif ied on both sides in one patient and on one side only in the remaining patient. Microvascular decompression cured the pain in two patients w ith neurovascular compression. The variable aetiology of trigeminal ne uralgia is stressed even in patients with coexistent neurological cond itions such as multiple sclerosis, which can cause trigeminal neuralgi a independent of other causes.