Secondary Trigeminal Neuralgia

The etiology of trigeminal neuralgia is basically caused by neurovascular conflict. However, there are cases where trigeminal neuralgia occurs due to other causes when encountering patients in clinical practice. This article summarizes the cases with other pathology among these cases. Among the things that can cause trigeminal neuralgia, the most easily encountered is the tumor located in a cerebello-pontine angle or Meckel’s cave. Among them, meningioma and schwannoma are the most common causes of secondary trigeminal neuralgia. In this case, treatment can be carried out in various ways. Some surgeons give priority to surgical resection of tumors, but other surgeons may treat it through stereotactic radiosurgery. If the tumor is removed through microscopic surgery and the trigeminal nerve is decompressed, the success rate is 86% and above. However, when applying stereotactic radiosurgery, the final pain relief rate is only 36%, with 28.3% of recurrence rate. There are also clear advantages of stereotactic radiosurgery. However, when trigeminal neuralgia is the main symptom, surgical resection is considered to be a more efficient and safe treatment.