The Journal of the American Dental Association
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J Am Dent Assoc, Vol 136, No 4, 469-476.
© 2005 American Dental Association

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COVER STORY

CASE REPORT

CASE REPORT
JADA Continuing Education

Trigeminal neuralgia in a patient with multiple sclerosis and chronic inflammatory demyelinating polyneuropathy



ELENI SARLANI, D.D.S., Ph.D., EDWARD G. GRACE, D.D.S., M.A., BIRUTE A. BALCIUNAS, D.D.S., M.S.D. and ANTHONY H. SCHWARTZ, D.D.S.

Background. Trigeminal neuralgia (TN) is characterized by unilateral, severe, brief, stabbing, recurrent pain in the distribution of one or more branches of the fifth cranial nerve. Symptomatic or secondary TN involves TN-like pain that develops owing to a central nervous system lesion (benign or malignant) or to multiple sclerosis (MS).

Case Description. The authors present a report of a unique case of a 43-year-old patient with unilateral TN, MS and concomitant chronic inflammatory demyelinating polyneuropathy. The facial pain preceded any other manifestations of the systemic disorders, and only after repeated neurological examinations were these diagnoses established.

Clinical Implications. Magnetic resonance imaging of the brain and repeated neurological evaluations should be implemented in all patients with TN to rule out the presence of underlying disease. The dental practitioner should be familiar with TN to avoid unnecessary dental interventions and ensure prompt initiation of appropriate treatment.

Key Words: Trigeminal neuralgia; multiple sclerosis; neuropathic pain; facial pain







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