Skip to main content

Advertisement

SpringerLink
Log in

Young-onset trigeminal neuralgia: a clinical study and literature review

  • Original Article - Functional Neurosurgery - Pain
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Objective

Trigeminal neuralgia (TN) primarily occurs in elderly adults and is thought to be induced by neurovascular compression. However, a few children and young adults may present with the clinical features of TN. In this study, we aim to retrospectively assess the data of young patients with TN from a single center.

Methods

Of 783 consecutive patients with TN treated at our center between 2007 and 2017, 11 young patients under the age of 30 years with TN met the inclusion criteria and were enrolled. Their clinical records, surgical treatments, and long-term outcomes were obtained and analyzed.

Results

All the 11 patients with TN underwent microvascular decompression (MVD). The average age at symptom onset was 24 years (range, 14–29 years), and the average age at the time of surgery was 28.9 years (range, 25–35 years). Further, 5 patients had left-sided symptoms, and 6 had right-sided symptoms. Surgery revealed only venous compression in 3 patients, only arterial compression in 5 patients, and both venous and arterial compression in 3 patients. The average duration of symptoms was 4.9 years, and the average follow-up duration was 7.4 years (range, 4.5–12.9 years). The long-term outcome was excellent in 9 patients and good in 2 patients, and there were no long-term complications.

Conclusions

The symptoms and surgical findings presented in this cohort for young-onset TN are similar to those reported in elderly adults. MVD appears to be a safe and effective treatment for young patients with TN.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Headache Classification Committee of the International Headache Society (IHS) (2018) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 38(1):1–211. https://doi.org/10.1177/0333102417738202

  2. Baechli H, Gratzl O (2007) Microvascular decompression in trigeminal neuralgia with no vascular compression. Eur Surg Res 39:51–57

    Article  CAS  Google Scholar 

  3. Bahgat D, Ray DK, Raslan AM, McCartney S, Burchiel KJ (2011) Trigeminal neuralgia in young adults. J Neurosurg 114:1306–1311

    Article  Google Scholar 

  4. Barclay JH (1922) A case of trigeminal neuralgia in a boy age 10 years, treated by intracranial division of the second and third divisions of the nerve. Br J Surg 9:306–308

    Article  Google Scholar 

  5. Barker FG 2nd, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD (1996) The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med 334:1077–1083

    Article  Google Scholar 

  6. Bender MT, Pradilla G, James C, Raza S, Lim M, Carson BS (2011) Surgical treatment of pediatric trigeminal neuralgia: case series and review of the literature. Childs Nerv Syst 27:2123–2129

    Article  Google Scholar 

  7. Cheng J, Meng J, Liu W, Zhang H, Hui X, Lei D (2018) Primary trigeminal neuralgia is associated with posterior fossa crowdedness: a prospective case-control study. J Clin Neurosci 47:89–92

    Article  Google Scholar 

  8. Chicoine NH, Yaacoub AP, Jea A, Raskin JS (2019) Surgical management of trigeminal neuralgia in children. World Neurosurg 121:217–221

    Article  Google Scholar 

  9. Childs AM, Meaney JF, Ferrie CD, Holland PC (2000) Neurovascular compression of the trigeminal and glossopharyngeal nerve: three case reports. Arch Dis Child 82:311–315

    Article  CAS  Google Scholar 

  10. Cutbush K, Atkinson RL (1994) Treatment of trigeminal neuralgia by posterior fossa microvascular decompression. Aust N Z J Surg 64:173–176

    Article  CAS  Google Scholar 

  11. Dubey A, Mujoo S, Sakarde SB, Dubey AK (2012) Paroxysmal neuralgia in pediatric population—a diagnostic dilemma for physicians and dental practioners. Kathmandu Univ Med J 10:74–77

    Article  CAS  Google Scholar 

  12. Grazzi L, Usai S, Rigamonti A (2005) Facial pain in children and adolescents. Neurol Sci 26(Suppl 2):s101-103

    Article  Google Scholar 

  13. Hamlyn PJ, King TT (1992) Neurovascular compression in trigeminal neuralgia: a clinical and anatomical study. J Neurosurg 76:948–954

    Article  CAS  Google Scholar 

  14. Harris W (1943) Trigeminal neuralgia at exceptionally early age. BMJ 2:39

    Article  CAS  Google Scholar 

  15. Iváñez V, Moreno M (1999) Trigeminal neuralgia in children as the only manifestation of Chiari I malformation. Rev Neurol 28:485–487

    PubMed  Google Scholar 

  16. Jannetta PJ (1967) Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg 26(Suppl):159–162

    Article  Google Scholar 

  17. Ko AL, Ozpinar A, Lee A, Raslan AM, McCartney S, Burchiel KJ (2015) Long-term efficacy and safety of internal neurolysis for trigeminal neuralgia without neurovascular compression. J Neurosurg 122:1048–1057

    Article  Google Scholar 

  18. Kolluri S, Heros RC (1984) Microvascular decompression for trigeminal neuralgia A five-year follow-up study. Surg Neurol 22:235–240

    Article  CAS  Google Scholar 

  19. Liu J, Yuan Y, Zang L, Fang Y, Liu H, Yu Y (2014) Hemifacial spasm and trigeminal neuralgia in Chiari's I malformation with hydrocephalus: case report and literature review. Clin Neurol Neurosurg 122:64–67

    Article  Google Scholar 

  20. Mason WE, Kollros P, Jannetta PJ (1991) Trigeminal neuralgia and its treatment in a 13-month-old child: a review and case report. J Craniomandib Disord 5:213–216

    CAS  PubMed  Google Scholar 

  21. Resnick DK, Levy EI, Jannetta PJ (1998) Microvascular decompression for pediatric onset trigeminal neuralgia. Neurosurgery 43:804–807 (discussion 807–808)

    Article  CAS  Google Scholar 

  22. Roski RA, Horwitz SJ, Spetzler RF (1982) Atypical trigeminal neuralgia in a 6-year-old boy. Case report. J Neurosurg 56:424–425

    Article  CAS  Google Scholar 

  23. Sabourin V, Mazza J, Garzon T, Head J, Ye D, Stefanelli A, Al Saiegh F, Lavergne P, Evans J (2020) Internal neurolysis with and without microvascular decompression for trigeminal neuralgia: case series. World Neurosurg 143:e70–e77

    Article  Google Scholar 

  24. Sindou MP, Chiha M, Mertens P (1994) Anatomical findings observed during microsurgical approaches of the cerebellopontine angle for vascular decompression in trigeminal neuralgia (350 cases). Stereotact Funct Neurosurg 63:203–207

    Article  CAS  Google Scholar 

  25. Solth A, Veelken N, Gottschalk J, Goebell E, Pothmann R, Kremer P (2008) Successful vascular decompression in an 11-year-old patient with trigeminal neuralgia. Childs Nerv Syst 24:763–766

    Article  CAS  Google Scholar 

  26. Tatli M, Satici O, Kanpolat Y, Sindou M (2008) Various surgical modalities for trigeminal neuralgia: literature study of respective long-term outcomes. Acta Neurochir 150:243–255

    Article  CAS  Google Scholar 

  27. Yue WL (2004) Peripheral glycerol injection for the relief of facial neuralgia in children. Int J Pediatr Otorhinolaryngol 68:37–41

    Article  Google Scholar 

  28. Zhang YQ, Yu F, Zhao ZY, Men XZ (2019) Combined hyperactive dysfunction syndrome of the cranial nerves: analysis of 37 cases and literature review. World Neurosurg 129:e650–e656

    Article  Google Scholar 

Download references

Funding

The government of China provided financial support in the form of a National Natural Science Foundation grant (No. 81671201), and the PLA 960th Hospital provided financial support in the form of a Research Fund Program grant (No. 2017ZX04). The sponsor had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Chinese PLA 960th Hospital, 25 Shifan Road, Jinan, 250031, Shandong Province, China

    Feng Yu

  2. Department of Neurosurgery, Tenth People’s Hospital of Tongji University, No. 301 Middle Yanchang Road, Shanghai, 200072, China

    Jia Yin

Authors
  1. Feng Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jia Yin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Feng Yu or Jia Yin.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board of our hospital and with the tenets of the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

This article does not contain any studies with human participants performed by any of the authors.

Conflict of interest

The authors declare no competing interests.

Additional information

Comments

The authors of this paper summarized their experience in management of trigeminal neuralgia (TN) in younger patients (under age of 30) - with 11 patients encountered over 11 year period. All patients were treated with microvascular decompression; the vascular compression was encountered in each of them, and in 8, the artery appeared to be a culprit (with or without venous involvement), whereas in remaining 3, the compression was purely venous. Nevertheless, all patients had remarkable improvement in their symptoms and there were no surgical complications.

This series underscores the fact that although TN tends to occur later in life, it can still be the case in younger patients with facial pain, and properly done surgery has an excellent chance of resolving the problem completely.

I would be very interested to learn whether the younger TN patients have some genetic predisposition to either development of neuropathic pain or some kind of weakness in myelination that translates vascular compression into TN pain generator. Perhaps future studies may focus on genetic evaluation of young-onset TN patients to facilitate better understanding of the TN pain origin.

Konstantin Slavin

Chicago, Ill, USA

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Functional Neurosurgery - Pain

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yu, F., Yin, J. Young-onset trigeminal neuralgia: a clinical study and literature review. Acta Neurochir 163, 1617–1621 (2021). https://doi.org/10.1007/s00701-021-04848-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-021-04848-6

Keywords

Search

Navigation