P070 | TRIGEMINAL NEURALGIA SECONDARY TO SOLITARY PONTINE LESION: CASE SERIES OF A PROPOSED NEW DIAGNOSTIC ENTITY

G. De Stefano¹, D. Litewzuk¹, D. Chiffi¹, E. Galosi¹, G. Di Pietro¹, E. Evangelisti¹, P. Falco¹, C. Leone¹, M. Kristt², R. Sekula², F. Caramia¹, A. Truini¹, G. Di Stefano¹ | ¹Department of Human Neuroscience, Sapienza University of Rome, Italy; ²Department of Neurological Surgery, Columbia University Irving Medical Center, New York, USA

Abstract

Background. Trigeminal neuralgia associated with a solitary pontine lesion is a new, recently described entity, characterized by the radiological evidence of a single pontine T2-hyperintense lesion affecting the intraxial course of primary trigeminal afferents in patients without a diagnosis of white matter disease. Although this new entity has received increasing attention, its underlying pathophysiology remains poorly understood.
Methods. In this multi-centre, retrospective study, we set out to determine the occurrence of TN related to solitary pontine lesion providing a systematic description of clinical features and the neurophysiological evidence of trigeminal afferent disfunction.
Results. From total of 200 patients with a definite diagnosis of TN, solitary pontine lesion was identified in 5% of cases.
Conclusions. The application of trigeminal reflex testing revealed the damage of primary trigeminal afferents. The high frequence of refractoriness to first line-drugs and surgical treatment suggests a more severe phenotype in comparison with classical TN and the need of tailored treatment.