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Primary brain stem tethering: a rare cause of geniculate neuralgia

Published online by Cambridge University Press:  29 June 2007

Geert G. Buyse ,
Jo Caekebeke ,
Philippe Demaerel  and
Chris Plets
Geert G. Buyse*
Affiliation:
Departments of Neurosurgery, University Hospital Gasthuisberg, Leuven, Belgium.
Jo Caekebeke
Affiliation:
Department of Neurologyt, Onze Lieve Vrouw Hospital, Aalst, Belgium.
Philippe Demaerel
Affiliation:
Departments of Radiology, University Hospital Gasthuisberg, Leuven, Belgium.
Chris Plets
Affiliation:
Departments of Neurosurgery, University Hospital Gasthuisberg, Leuven, Belgium.
*
Address for correspondence: Geert G. Buyse, Department of Neurosurgery, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium. Fax: 00 32 16 34 42 85
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Abstract

This rare case of brain stem tethering presented with chronic and progressive geniculate neuralgia. In view of the fact that an occipital subcutaneous lipoma had been resected in childhood, it probably concerned a primary tethering, fitting in with an occult occipital dysraphism.

Magnetic resonance imaging (MRI) clearly demonstrated an underlying tethering, causing a distortion of the brain stem. Consequently, this led to the hypothesis that the geniculate neuralgia could be explained by traction on the lower cranial nerves secondary to the brain stem displacement. Untethering resulted in a considerable decrease of the neuralgia.

MRI proved to be essential in the diagnosis and treatment of this unusual case.

Keywords

Geniculate ganglionNeuralgia
Type
Radiology in focus
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 10 , October 1999 , pp. 945 - 947
Copyright
Copyright © JLO (1984) Limited 1999

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References

Clark, L. P., Taylor, A. S. (1909) True tic douloureux of the sensory filaments of the facial nerve. I. Clinical report of a case in which cure was affected by physiological extirpation of the geniculate ganglion. II. Report of surgical treatment. Journal of the American Medical Association 53: 2144–2146.Google Scholar
Comey, C. H., Albright, L. A. (1994) Symptomatic tethering of the cerebellar vermis: case report. Neurosurgery 34: 177–180.Google Scholar
Hunt, J. R. (1907) On herpetic inflammations of the geniculate ganglion. A new syndrome and its complications. Journal of Nervous and Mental Disorders 34: 73–96.Google Scholar
Jannetta, P. J. (1975) Trigeminal neuralgia and hemifacial spasm: etiology and definitive treatment. Transactions of the American Neurological Association 100: 89–91.Google Scholar
Kernan, J. C, Horgan, M. A., Piatt, J. H. (1996) Tethered hindbrain. Case report. Journal of Neurosurgery 85: 713–715.Google Scholar
Lillie, H. I., Craig, W. M. (1936) Anomalous vascular lesion in the cerebellopontine angle. Severe neuralgic pain in the ear and profound nervous disturbance, operation and recovery. Archives of Otolaryngology 23: 642–645.Google Scholar
Liu, L. C, Ciacci, J. D., George, T. M. (1995) Brain stem tethering in Dandy-Walker syndrome: a complication of cystoperitoneal shunting. Case report. Journal of Neurosurgery 83: 1072–1074.Google Scholar
Lovely, T. J., Jannetta, P. J. (1997) Surgical management of geniculate neuralgia. American Journal of Otology 18: 512–517.Google Scholar
Pulec, J. L. (1976) Geniculate neuralgia: diagnosis and surgical management. Laryngoscope 86: 955–964.Google Scholar
Reichert, F. L. (1933) Tympanic plexous neuralgia. True tic douloureux of the ear or so-called geniculate ganglion: cure effected by intracranial section of the glossopharyngeal nerve. Journal of the American Medical Association 100: 1744–1746.Google Scholar
Rosen, S. (1953) Tic douloureux of the chorda tympani. Report of cases. Archives of Neurology and Psychiatry 69: 375–378.Google Scholar
Rupa, V., Saunders, R. L., Weider, D. J. (1991) Geniculate neuralgia: the surgical management of primary otalgia. Journal of Neurosurgery 75: 505–511.CrossRefGoogle ScholarPubMed