Rabadi Meheroz H
Oklahoma City VA Medical Center, OK, USA.
Department of Neurology at the Oklahoma University Health Sciences Center, OK, USA.
Radiol Case Rep. 2024 Jun 5;19(8):3545-3547. doi: 10.1016/j.radcr.2024.05.035. eCollection 2024 Aug.
I present here a case of trigeminal neuralgia (TGN), which is a highly disabling disorder characterized by brief and recurrent shock-like episodes of facial pain. TGN occurs in 2% of people with MS. A 54-year-old woman diagnosed with multiple sclerosis (MS) in 2008 and who was in remission stopped taking her disease-modifying therapy (DMT) in 2018 due to a lack of relapses presented to our facility with excruciating right facial pain. Magnetic resonance imaging (MRI) of the brain with gadolinium showed enhancing plaque involving the proximal cisternal portion of the right trigeminal nerve on axial and sagittal sections. She was started on carbamazepine 300 mg 4 times a day. This case highlights the need for early diagnosis by MRI with gadolinium enhancement and prompt initiation of treatment helped her pain to subside and was able to return a week later to the MS clinic to be restarted on her prior DMT to prevent further MS relapses.
我在此呈现一例三叉神经痛（TGN）病例，这是一种极具致残性的疾病，其特征为面部疼痛呈短暂且反复发作的电击样发作。TGN在2%的多发性硬化症（MS）患者中出现。一名54岁女性于2008年被诊断为多发性硬化症，病情缓解后，因未再复发，于2018年停止服用疾病修正治疗药物（DMT），后因右侧面部剧痛前来我院就诊。头颅钆增强磁共振成像（MRI）轴向及矢状面显示，右侧三叉神经近端脑池段有强化斑块。她开始服用卡马西平，每日4次，每次300毫克。该病例凸显了通过钆增强MRI进行早期诊断的必要性，及时开始治疗有助于缓解她的疼痛，一周后她能够返回MS诊所重新开始服用先前的DMT，以预防MS进一步复发。
