MRI characteristics of trigeminal nerve involvement in patients with multiple sclerosis

BackgroundTrigeminal neuralgia and central sensory disturbances are common in patients with multiple sclerosis. The anatomic correlation to lesions in the trigeminal nuclei in the brainstem is not well studied.ObjectiveWe studied the anatomical characteristics of demyelinating lesions of the trigeminal complex in the brainstem on MRI in patients with MS and Clinically Isolated syndrome (CIS).Materials and methods43 Patients with MS or CIS and MRI lesions in the trigeminal complex in the brainstem were selected from a large database of patients referred for MRI because of trigeminal symptoms.Results and conclusionA linear plaque involving the intrapontine fascicular part of the trigeminal nerve and lesions of the spinal trigeminal nucleus and tract seem to be distinctive MRI findings in patients with RRMS or CIS.

► Trigeminal neuralgia and trigeminal sensible loss are frequent symptoms in MS.
► Brainstem lesions in MS are generally considered heterogeneous in their appearance and distribution.
► In patients with MS and CIS, lesions in the intrapontine fascicular part of the trigeminal complex seem to be more frequent.
► In patients with MS and CIS, lesions in the spinal tract and nucleus of the trigeminal complex seem to be more frequent.
► Lesions in these two anatomical regions of the brainstem can be considered distinctive MRI findings in patients with MS or CIS.