Is Trigeminal Neuralgia A Sign Of Multiple Sclerosis & Does It Show Up On MRI?

Trigeminal neuralgia is not always caused due to multiple sclerosis. Multiple sclerosis is one of the cause for trigeminal neuralgia. Other possible causes include nerve injury, cyst or arteriovenous malformations. MRI may help to reveal the compression of the trigeminal nerve by vessels.

Multiple sclerosis is a disease of the brain and spinal cord or central nervous system. In multiple sclerosis the flow of information between the brain and body gets imbalanced. In this condition, the immune system of the body attacks the protective sheath that covers the nerve fiber. In this condition, the nerve may get permanently damaged1, when the nerve it leads to the development of “sclerosis” or scar tissue. When nerve fibers are damage electric impulse conducting ability may partially or completely be lost. The causes of the multiple sclerosis are not known but some genetic and environmental factors work as a trigger of this disease2.

Is Trigeminal Neuralgia A Sign Of Multiple Sclerosis?

How multiple sclerosis causes trigeminal neuralgia? Nerves are protected through the outer layer called the myelin sheath. Myelin sheath is responsible for proper protection and helps in the condition of nerve impulses without any dissipation of impulses in the external environment. Multiple sclerosis is an autoimmune disease with neurodegenerative characteristics. The immune system of the body attacks and damages the myelin sheath. This results in poor conduction of nerve impulse and other neuropathic symptoms. If the immune system attacks the trigeminal nerve, the nerve gets demyelinated. On demyelination, the nerve gets extremely sensitive to compression by blood vessels leading to trigeminal neuralgia. Only slight compression in patients with affected trigeminal nerve results in trigeminal neuralgia attack. However, in some patients without multiple sclerosis, trigeminal neuralgia is caused by the blood vessels press the nerve under the skull and such process is known as nerve compression4.

Symptoms Of Multiple Sclerosis

Numbness and Weakness: As the nerve condition is severely hampered in multiple sclerosis, the patient may experience numbness and weakness in various parts especially in peripheral organs.

Electric-Shock Sensations: Electric shock sensations are experienced during neck movement especially when bending the neck. These symptoms are also referred to as laharmitte’s sign2.

Vision Problems: Patients may also develop vision problems which include blurry vision, complete loss of vision and prolonged double vision. The patient may also feel pain in the eye during eye movement3.

Thinking Problems: Patients with multiple sclerosis have some thinking problems such as poor focus, fuzzy memory and the capacity of thinking are slow.

Bladder Problems: The patients with Multiple Sclerosis loss their control on the bladder. Thus, patients have difficulty in emptying the bladder. This is an early sign of the MS.

Pain: Neuropathic pain is a common symptom of the MS. Pain occurs because of weakness and stiff in the body. Nephrotic pain also occurs in multiple sclerosis.

Dizziness and Balance: coordination and balance can decrease the mobility of patient suffering from multiple sclerosis.

Change in Emotional Health: Patients with MS also suffering from depression and stress. The stress leads to irritability and extreme mood swing, a condition known as pseudobulbar affect3.

Does It Show Up On MRI?

The doctor may advise many types of test for the diagnosis of trigeminal neuralgia and determining the causes of the patient’s condition.

A Neurological Examination: Doctor determines the site of trigeminal neuralgia by touching and examine the part of the face.

Reflex Test: A reflex test is performed for confirmation of the integrity of the spinal cord and for determination of spinal cord injury or any other neuromuscular disease.

Magnetic Resonance Imaging (MRI): Magnetic resonance imaging is done for the determination of tumor that causes trigeminal neuralgia. In some cases, a dye is administered in the blood vessels to view the artery, vein and to highlight blood vessels. The technique used in highlighting vessels is known as magnetic resonance angiogram5.

Conclusion

Multiple sclerosis causes demyelination of nerves. If the trigeminal nerve gets affected, the chances of trigeminal neuralgia attack are increased. Magnetic resonance angiography is the techniques to analyze the compression of the trigeminal nerve.

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