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Diagn Interv Imaging. 2013 Oct;94(10):993-1001. doi: 10.1016/j.diii.2013.08.002. Epub 2013 Sep 3.

Trigeminal neuralgia.

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Neuroradiology Department, Pitié-Salpêtrière Hospital Group, UPMC, 47-83, boulevard de l'Hôpital, 75013 Paris, France. Electronic address:


Two different clinical entities, essential or secondary neuralgia, are associated with different pathologies. The pathways of CN V comprise the cervical spine, the brainstem, the root of the nerve and the three peripheral branches: V1, V2 and V3. The lesions responsible for neuralgia are neoplastic, vascular, inflammatory, malformative or post-traumatic. The examination protocol should explore the set of CN V pathways. Neurovascular compression is the main cause of essential neuralgia. It is investigated by T2-weighted inframillimetric volume. Two conditions are necessary to diagnose a neurovascular compression: localised on the root entry zone [(REZ), 2-6mm from the emergence of the pons] and perpendicularly. In the absence of neurovascular compression, thin slices and a gadolinium injection are necessary.


Cranial nerves; Pain; Trigeminal neuralgia

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