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Volume 31 , Issue 4
Fall 2017

Pages e10e14

Congenital Epidermoid Cyst Presenting as Isolated Painful Trigeminal Neuropathy: Indications for Neuroimaging in the Diagnostic Process

Kimberley Kok, MBBS, MA, PGCert, MRCP (UK)/Chris Sproat, MBBS (Hons), BDS, BSc (Hons), FDSRCS (Eng)/Mun-Seng Chong, BSc (Hons), MBBS, MD, FRCP/Chris Chandler, BSc, MBBS, FRCS (SN)/Nick Thomas, MBBS, FRCS (Glas), FRCS (Eng), FRCS (SN)/Hoong-Wei Gan, BMedSci (Hons), BMBS, MSc, MRCPCH

PMID: 29073668
DOI: 10.11607/ofph.1949

This article reports a case of a cerebellopontine angle epidermoid cyst presenting as isolated painful trigeminal neuropathy. The indolent nature of these uncommon benign tumors leads to frequent delays in their presentation and diagnosis, with patients often initially undergoing dental procedures. This is illustrated in the present case reported here, which highlights the difficulties in identifying trigeminal neuralgia (TN), particularly in its early phases, and supports current recommendations for routine neuroimaging in suspected cases of painful trigeminal neuropathy, which, unlike classic TN, is caused by a disorder other than neurovascular compression (even in the absence of additional neurologic symptoms or signs) and is present particularly in younger patients with atypical features. Additionally, this case report offers a unique patient perspective of living with TN, with a detailed description by one of the authors of the nature of the pain and its impact.

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