Trigeminal neuralgia due to vertebrobasilar dolichoectasia: Three case reports

We report here 3 cases of trigeminal neuralgia (TN) due to vertebrobasilar dolichoectasia (VBD) and discuss the clinician's role in such cases. All cases presented at our clinic with paroxysmal, electric shock–like pain over their maxillary or mandibular gingiva. To confirm a diagnosis of TN, magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) were performed, and contact of the trigeminal nerve with a tortuous vertebrobasilar artery (VBA) was detected. Patients were informed about the therapeutic algorithm of TN before starting treatment. When medication became ineffective, the patients were referred to a neurosurgeon, and microvascular decompression (MVD) was consequently performed in 1 patient and radiofrequency thermocoagulation (RFTC) in the other 2 cases. VBD is associated with the risk of serious complications during follow-up and some limitations regarding second-line treatment. Dentists have a significant role in controlling orofacial pain and must be aware of this specific etiopathology of TN.