[Trigeminal neuralgia in children as the only manifestation of Chiari I malformation].
OBJECTIVE
The appearance of trigeminal neuralgia in infancy is exceptional. Trigeminal neuralgia as the only manifestation of a Chiari malformation is also infrequent. We present the case of a patient with a Chiari type I malformation in which the only symptom was the presence of trigeminal neuralgia since infancy. We have found no similar cases in the literature.


METHODS
A 39 year old man with no significant clinical history complained of brief, recurrent episodes of pain in the right maxillary region, compatible with trigeminal neuralgia since the age of eight. The frequency, duration and intensity of these episodes had progressively increased. The only unusual finding on physical examination was a sluggish right corneal reflex. Cranial MR showed descent of the cerebellar tonsils to below the level of the posterior arch of the atlas, together with slight descent of the brainstem. These findings are characteristic of a Chiari type I malformation. The symptoms rapidly disappeared when treatment was started with carbamazepine.


CONCLUSIONS
In exceptional cases, trigeminal neuralgia may present in infancy and be the only manifestation of a Chiari malformation.
Iváñez
V
V
Servicio de Neurología, Hospital Universitario La Paz, Universidad Autónoma, Madrid, España.
Moreno
M
M
D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000175:diagnosis*; D002220:Carbamazepine / Q000627:therapeutic use; D002531:Cerebellum / Q000473:pathology; D003937:Diagnosis, Differential; D018450:Disease Progression; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D014277:Trigeminal Neuralgia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*
D018712:Analgesics, Non-Narcotic; D002220:Carbamazepine