Cervical Discopathy in Idiopathic Trigeminal Neuralgia: More than Coincidence?

BackgroundThe most common cause of trigeminal neuralgia (TN) is neurovascular compression. However, a number of patients present with unknown etiology. This study aims to investigate the relationship between TN and cervical pathology in patients previously diagnosed with idiopathic TN. MethodsWe designed an observational case-control study. A study group consisting of patients previously diagnosed with idiopathic TN and a control group was included in the study. Cranial MRI’s of TN patients were re-evaluated by a blinded neuroradiologist. Once it was confirmed that no signs of neurovascular compression or any secondary causes were present, a cervical MRI was performed to evaluate cervical pathologies. Results20 patients and 20 controls were investigated. The mean age of TN patients was 64.9±12.6, and the mean age of the control group was 61.3±9.1 (p=0.305). Whilst indentation on the trigeminal spinal tract above C4 spinal level was observed in 12 out of 20 patients, none of the controls had any involvement in the same region (p<0.001). ConclusionsThe results of this study suggest that extramedullary indentation on the trigeminal spinal tract caused by upper cervical discopathy may be one of the possible etiological factors in TN.