Kok, K; Sproat, C; Chong, M-S; Chandler, C; Thomas, N; Gan, H-W; (2017) Congenital Epidermoid Cyst Presenting as Isolated Painful Trigeminal Neuropathy: Indications for Neuroimaging in the Diagnostic Process. Journal of Oral & Facial Pain and Headache , 31 (4) E10-E14. 10.11607/ofph.1949.

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Abstract

This article reports a case of a cerebellopontine angle epidermoid cyst presenting as isolated painful trigeminal neuropathy. The indolent nature of these uncommon benign tumours leads to frequent delays in their presentation and diagnosis, with patients often initially undergoing dental procedures, as illustrated here. This case 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 classical TN, is caused by another disorder other than neurovascular compression), particularly in younger patients with atypical features, even in the absence of additional neurological symptoms or signs. Additionally, it offers a unique patient perspective of living with TN, with a detailed description of the nature of the pain and its impact by one of the authors.

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