Abstract
The authors experienced a case of trigeminal neuralgia (TN) successfully treated with a nerve block, which incidentally led to the discovery of a meningioma. A 78-year-old male complaining of throbbing pain in the right nasal cavity underwent an otolaryngological examination, which revealed no abnormalities. Idiopathic TN was diagnosed, and the patient was prescribed carbamazepine (CBZ). Because the CBZ caused dizziness, he was referred to anesthesiology. The authors performed a single right infraorbital nerve block with high-concentration tetracaine, which successfully relieved his pain. Although the patient discontinued CBZ, his dizziness remained. A head CT scan revealed a meningioma at the cerebellopontine angle, which was then surgically removed. Since undergoing the infraorbital block, the patient's pain has not recurred even after one year. The “take-home” lessons of this case are twofold: (1) the importance of excluding the diagnosis of symptomatic TN even in a patient with typical idiopathic TN; (2) the importance of taking MRI into consideration when treating patients with TN.
