Signos de alarma en neuralgia del trigémino / Alarm signs in trigeminal neuralgia

RESUMEN

La neuralgia del trigémino es característica en personas mayores de 50 años, comprometiendo principalmente el territorio V2 y V3 de dicho nervio de manera unilateral y la carbamezepina es el fármaco con mayor efectividad, pero no siempre responden. La presentación atípica y los signos de alarma ponen en consideración el estudio con resonancia magnética cerebral, pues obliga a descartar una causa secundaria, siendo necesario el análisis de neuroimágenes. Debido a esto, presentamos un caso de quiste epidermoide con neuralgia secundaria, que se presenta con signos de alarma y se deben considerar los estudios complementarios.

ABSTRACT

Classic trigeminal neuralgia (TN) is most common after 50 years of age, predominantly unilateral within the distribution of the V2 and V3 branches of the trigeminal nerve. Carbamazepine is the most effective medication, although not all patients respond to it. In consideration physicians should arrange a brain magnetic resonance imaging study when facing TN patients with atypical presentation and alarm signs, as secondary causes must be ruled out. We present a case of epidermoid cyst with secondary TN which presented with "red flag" signs. Image studies were therefore mandatory.