William Lines-AguilarINCN – National Institute of Neurological Sciences, Peru
Title: Trigeminal Neuralgia Secondary to Neurocysticercosis
Trigeminal neuralgia (TN) is the most common type of facial pain, negatively affecting quality of life and work capacity in 34% of cases. It has a prevalence of 4-13 cases per 100,000 inhabitants, generally affects patients over 50 years of age and with a ratio of 1.5 to 1 higher in women. In primary (classic) TN, a vascular loop compresses the trigeminal nerve at its entrance to the brain stem. Secondary forms are due to extrinsic compression of the trigeminal nerve. Of these, the most common causes are tumors (meningiomas, epidermoid cysts, acoustic neuromas, etc.) and less frequently aneurysms, arteriovenous malformations and other more rare causes. Pathophysiological changes in secondary TN are similar to those of primary TN, although the structural lesion causing the compression varies according to the etiology (in example, demyelination plaques in multiple sclerosis). The standard treatment for both primary and secondary TN is microsurgical decompression of the trigeminal nerve. TN secondary to neurocysticercosis (NCC) is very rare. TN associated with NCC has been reported in relation to direct compression by cysts (with improvement in pain after cyst exeresis), contralateral to cystic lesions (with improvement after resection of cysts in the contralateral hemisphere), and even rarer cases of bilateral TN with bilateral pain improvement after resection of single-sided cysts. In all cases a retrosigmoid approach was used without complications. We present two cases of TN associated with NCC cysts, one was treated with a classic retrosigmoid approach and the other with an endoscopic endonasal approach, in both cases with pain relief and no complications.
William Lines-Aguilar completed the specialty of Neurosurgery at the National Institute of Neurological Sciences of Peru, and a High Specialty Course in Skull Base Surgery and Endoneurosurgery at the National Institute of Neurology and Neurosurgery in Mexico. He is currently Head of the Skull Base and Endoneurosurgery Unit of the National Institute of Neurological Sciences in Lima, Peru. Dr. Lines has authored multiple publications in renowned peer-reviewed neurosurgery journals, and is also a member of the Institutional Research and Ethics Committee.