孤発性三叉神経症で発症したroot entry zone部橋梗塞の2症例

Isolated Trigeminal Sensory Neuropathy due to Pontine Infarction of the Root Entry Zone―Report of Two Cases

はじめに

　三叉神経痛や三叉神経症が単独で発症した場合，微小血管や腫瘍による三叉神経圧迫，多発性硬化症や帯状疱疹による三叉神経損傷が考えられる。脳梗塞^1－11）や脳出血^12）などの脳血管障害によって三叉神経症や三叉神経痛を単独発症した報告は非常に稀である。今回われわれは，橋梗塞により孤発性三叉神経症を呈した2症例を経験したので，文献的考察を加えて報告する。

Abstract

　Secondary trigeminal neuralgia and isolated trigeminal neuropathy due to ischemic lesion of the pons are very rare.　We report 2 patients with pontine infarct transecting the central trigeminal pathways resulting in trigeminal neuropathy and/or neuralgia.　Case 1: A 48-year-old female presented with lancinating pain and paresthesia and hypesthesia in the right V2 and V3 distributions.　Magnetic resonance imaging (MRI) of the brain demonstrated a wedge-shaped infarct at the root entry zone (REZ) of the right trigeminal nerve in the pons.　Case 2: A 66-year-old female presented with paresthesia and hypesthesia in the right V1, V2 and V3 distributions.　MRI demonstrated a small wedge-shaped infarct at REZ.　This infarction of the REZ may have led to produce the isolated trigeminal neuralgia and trigeminal neuropathy.