Role of 3D-Constructive Interference in Steady State (3D-CISS) Sequence of Magnetic Resonance Imaging in Evaluation of Trigeminal Neuralgia

Author(s): Arul Thangaraj Dasan1 , Rakshith Ranganath2 , Shweta Raviraj Poojary3 , Neeraja Akki4

BACKGROUND Trigeminal neuralgia is one of the most debilitating facial pain disorders. Differentiation among various aetiologies is important because the treatment strategy changes. MRI helps in diagnosing the disease, finding the cause for neuralgia and follow up of patients after treatment. We wanted to evaluate the aetiology among patients clinically suspected to be suffering from trigeminal neuralgia using 3D CISS sequence of Magnetic Resonance Imaging (MRI). METHODS A hospital based cross-sectional study was done from November 2017 to May 2019 in a tertiary care centre of South India, where 56 patients with clinical suspicion of Trigeminal neuralgia were evaluated with MRI of brain. The MRI data collected was analysed and described. RESULTS Out of 56 patients in our study group, 24 (42.9%) were males and 32 (57.1%) were females, with slightly more female predilection. Majority of patients was in the 5th decade (23.2%). Neurovascular compression was the most common aetiology accounting for 71.1% of the patients, followed by tumours (15.8%), demyelination (7.9%) and infarct (5.3%) aetiologies. CONCLUSIONS MRI is the best imaging modality for evaluation of trigeminal neuralgia. 3D CISS sequence helps in better depiction of neurovascular conflicts. It is the most sensitive and specific tool for characterisation of tumours involving cerebellopontine angle, although the final tool for confirmation is histopathology. The present study was aimed at evaluating the causes of trigeminal neuralgia on MRI. This was done by correlating MRI findings with clinical features.