Trigeminal schwannoma: features of diagnosis and treatment (case report and review of literature)

L.A. Dzyak, A.G. Sirko, D.M. Romanukha


We consider the clinical cases of rare pathology — trigeminal schwannoma (TS) in a woman aged 50 years. According to review of literature and own observations, the main differential signs of TS were: hypesthesia, hemifacial numbness and their combination with trigeminal neuralgia (TN) on the same side, masseter muscle paralysis. Neuralgia in this neoplasm is symptomatic (secondary), caused by compression by tumor masses and also has its own characteristic manifestations, in contrast to classical TN. Pain is dull, combined with numbness of the face, attack is longer, not always characterized by specific trigger mechanisms, poorly or not susceptible to medical treatment. The surgical approach to the treatment of TS is considered a method of choice. After total removal of the tumor, the patient noted a gradual regression of numbness in the face. Attacks of TN were not registered in the postoperative period. All patients with TN should undergo magnetic resonance imaging of the brain with the mandatory inclusion in the study protocol of the visualization of the cranial nerves in order to detect neurovascular conflict or other causes of neuralgia.


trigeminal schwannoma; trigeminal neuralgia; symptomatic neuralgia; secondary neuralgia; surgical treatment; diffe­rential diagnosis


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