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Facial Pain Mimicking Trigeminal Neuralgia Secondary to Low-Cervical Spondylosis: A Case Report and Comprehensive Literature Review

Year: 2025

Type: article

Abstract: Trigeminal neuralgia (TN) is usually associated with neurovascular compression at the root entry zone. However, atypical presentations may result from secondary underlying pathologies. Cervical spondylosis (CS) is a rare cause, and its pathophysiologic mechanism leading to facial pain remains poorly understood. Here, we present a case of a 53-year-old woman with a one-year history of migraine episodes refractory to multiple medications. She subsequently developed sudden, severe left-sided trigeminal-like facial pain. Brain magnetic resonance imaging (MRI) excluded vascular compression or intracranial pathology, while cervical spine MRI revealed disc bulging at lower cervical levels. The patient underwent anterior cervical discectomy and fusion (ACDF) at C5-C6, achieving immediate and sustained resolution of facial pain and migraines. This case highlights the importance of evaluating the entire trigeminal pathway, including the cervical spine, when assessing patients with atypical or refractory TN, as an appropriate diagnostic approach and surgical management can lead to definitive symptom relief.

Source: Cureus

DOI: 10.7759/cureus.96445

Authors: Gerardo Gomez-Castro, Luis A Castillejo-Adalid, Gonzalo Cancino-Gonzalez, Mario A Taylor-Martinez, Ulises Garcia-Gonzalez

Institutions: Universidad de Guanajuato, Institute for Social Security and Services for State Workers

Language: English

Topic: Trigeminal Neuralgia and Treatments

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4416058346