A delayed diagnosis of left trigeminal neuralgia with tinititus secondary to trigeminal schwannoma at oral medicine department, khyber college of dentistry, peshawar:a case report

Zafar Ali Khan., Ammar Ahmed Siddiqui and Yazeed Saud Altamimi

Background: Trigeminal neuralgia (TN) greatly affects quality of life (QOL) as slightest stimulation of various trigger zones on the face and inside the mouth may trigger a painful episode, thus preventing the patient from speaking, eating, drinking, touching or washing of the face and brushing teeth. Trigeminal schwannomas are rare benign tumors that may present with TN like pain.
Case Report: 55 year old gentleman presented with severe lanciating episodic pain on the left side of his face along with tinititus in the left ear, loss of corneal reflex and sleep disturbance due to pain. The pain was earlier misdiagnosed as a tooth ache that resulted in some of his teeth being unnecessarily extracted. A multiecho and multiplanar imaging through the brain revealed 1.8 x 1.5 x 1.5cm sized T1W/T2W iso-intense mass along the left antero-lateral aspect of the pons in the region of trigeminal nerve showing intense enhancement of post-gadolinium images suggestive of trigeminal schwannoma.
Conclusion:After meticulous history and methodical clinical examination with a focus on detailed assessment of cranial nerves Magnetic Resonance Imagining(MRI) is mandatory gold standard for timely exclusion of intra-cranial space occupying lesion in patients with long history of TN.

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DOI: http://dx.doi.org/10.24327/ijcar.2017.7491.1162
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