Clinical characteristics,identification,and treatment of trigeminal neuralgia misdiagnosed as odontogenic pain (with analysis of 24 cases)

QI Meng; JIANG Lidan; SUN Peng; TANG Lu; LIANG Jiantao; GUO Hongchuan

doi:10.3969/j.issn.1002-266X.2017.35.028

Abstract：Objective To investigate the clinical characteristics,differentiation diagnosis and treatment experience of trigeminal neuralgia misdiagnosed as odontogenic pain. Methods We retrospectively analyzed the clinical data of 24 cases with trigeminal neuralgia misdiagnosed as odontogenic pain. Results Of all 105 cases of trigeminal neuralgia,24 cases (22. 9%)had been misdiagnosed as odontogenic pain,including 11 male (45. 8%)and 13 female (54. 2%)patients, with age of 41-78 (56. 8 ± 8. 8)years at admission. The distribution area of pain were involved with trigeminal nerve Ⅱbranch in 5 cases (20. 8%)and Ⅱ&Ⅲ branches in 19 cases (79. 2%). All 24 cases had visited stomatology department or clinic with diagnosis of odontogenic pain and related treatment,including 8 cases with tooth extraction. Patients were di-agnosed as trigeminal neuralgia after the consultation with pain department,neurology department or neurosurgery depart-ment with assistance of head MRI specific sequences. Twenty cases of primary trigeminal neuralgia received microvascular decompression and 2 cases of secondary trigeminal neuralgia received resection of cerebellopontine angle mass,with allevia-tion of symptom after surgery in the early period. Conclusions The trigeminal neuralgia misdiagnosed as odontogenic pain are mostly involved with trigeminal nerve Ⅱ branch or Ⅱ& Ⅲ branches. To identify the odontogenic pain and trigeminal neuralgia,we should carefully ask the patients′ medical history,understand the characteristics of pain,and then select the appropriate means of examination,such as head MRI specific sequence. For primary trigeminal neuralgia and the secondary trigeminal neuralgia,we should choose the different treatment methods.