Advertisement

MRI findings in trigeminal neuropathy: bilateral Meckel’s cave lesions

  • Philipp KarschniaEmail author
  • Soma Sengupta
  • Jorg Dietrich
Neuro-Images
  • 9 Downloads

A 43-year-old woman presented during wintertime after a 2-day episode of acute facial pain in the ophthalmic (V1) division of the right trigeminal nerve, and numbness in both the right maxillary (V2) and mandibular (V3) divisions. Her history was remarkable for seronegative arthritis and bronchiolitis obliterans with organizing pneumonia (BOOP), though she was not on immunosuppressive therapy. Symptoms spontaneously resolved, and no focal findings were appreciated on neurological examination. CRP was 9.3 mg/L, ANA was positive at 1:160, and ACE level was within normal range. Magnetic resonance imaging (MRI) revealed an enhancing expansile mass within the right Meckel’s cave extending into the right foramen ovale (Fig. 1a, d). Computed tomography of the chest showed changes consistent with BOOP and new nodules measuring < 5 mm in size of undetermined etiology. Given that the patient was asymptomatic, she was monitored with surveillance MRI which was stable after 6 months. Repeat MRI of...

Keywords

Pain Meckel’s cave Tumor Autoimmune Imaging 

Notes

Author contributions

PK: study concept and design, analysis and interpretation of data, and drafting and revising of manuscript. SS: analysis and interpretation of data, drafting and revising of manuscript. JD: study concept and design, analysis and interpretation of data, drafting and revising of manuscript.

Funding

No funding to report.

Compliance with ethical standards

Conflict of interest

Mr. Karschnia reports no disclosures. Dr. Sengupta reports no disclosures. Dr. Dietrich reports no disclosures.

Ethical approval

The authors acted in accordance with the ethical standards of the institutional research committee and the 1964 Helsinki declaration. The article does not contain experimental studies with human participants or animals performed by the authors.

Informed consent

Informed consent was obtained from the patient.

References

  1. 1.
    Gelfand JM (2017) Demystifying neurosarcoidosis and informing prognosis. JAMA Neurol 74:1296–1298CrossRefGoogle Scholar
  2. 2.
    Janjua RM, Wong KM, Parekh A et al (2010) Management of the great mimicker: Meckel cave tumors. Neurosurgery 67:416–421Google Scholar
  3. 3.
    Joubert B, Chapelon-Abric C, Biard L et al (2017) Association of prognostic factors and immunosuppressive treatment with long-term outcomes in neurosarcoidosis. JAMA Neurol 74:1336–1344CrossRefGoogle Scholar
  4. 4.
    Malhotra A, Tu L, Kalra VB et al (2018) Neuroimaging of Meckel’s cave in normal and disease conditions. Insights Imaging 9:499–510CrossRefGoogle Scholar
  5. 5.
    Valeyre D, Prasse A, Nunes H et al (2014) Sarcoidosis. Lancet 383:1155–1167CrossRefGoogle Scholar

Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  • Philipp Karschnia
    • 1
    • 2
    • 3
    Email author
  • Soma Sengupta
    • 4
  • Jorg Dietrich
    • 1
    • 2
  1. 1.Department of NeurologyMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Division of Neuro-OncologyMassachusetts General Hospital Cancer Center, Harvard Medical SchoolBostonUSA
  3. 3.Department of NeurologyYale School of MedicineNew HavenUSA
  4. 4.Department of NeurologyEmory University School of MedicineAtlantaUSA

Personalised recommendations