Atypical Trigeminal Neuralgia Following Dental Procedure: Investigating Potential Hematoma

Case at a Glance

A 30-year-old female developed atypical trigeminal neuralgia immediately following a root canal procedure with multiple local anesthetic injections. Patient and family are investigating the possibility of procedure-related hematoma as an underlying cause.

Patient's Story

The patient, a 30-year-old female weighing 100 pounds, underwent a routine root canal procedure several months prior to presentation. During the procedure, she received multiple injections of local anesthesia in the upper gum area. Immediately following the dental work, she began experiencing symptoms consistent with atypical trigeminal neuralgia. She was subsequently diagnosed with this condition and prescribed gabapentin for symptom management.

Initial Assessment

Patient presented with newly onset facial pain following dental intervention. Given the temporal relationship between the dental procedure and symptom onset, a thorough neurological evaluation was initiated. The patient's medical history was otherwise unremarkable, and she had no prior episodes of facial pain or neurological symptoms.

The Diagnostic Journey

An MRI was obtained to rule out structural causes such as tumors or vascular compression of the trigeminal nerve. The family researched potential connections between mechanical trauma from dental procedures and trigeminal neuralgia, discovering literature suggesting that hematomas from needle trauma could potentially cause neuralgic symptoms. They sought guidance on interpreting the MRI findings and identifying potential hematomas.

Final Diagnosis

Atypical trigeminal neuralgia, likely post-procedural. The exact etiology remains under investigation, with consideration of potential mechanical trauma-related hematoma as a contributing factor.

Treatment Plan

Current management includes gabapentin therapy for neuropathic pain control. Further neurological consultation is planned, though availability is limited in the patient's geographic area. Consideration for specialized facial MRI imaging if symptoms persist or worsen.

Outcome and Follow-up

Patient continues on current medication regimen with ongoing symptom monitoring. Family education provided regarding MRI interpretation limitations and the importance of professional radiological review. Long-term neurological follow-up arranged despite scheduling challenges in the region.