Trigeminal Neuralgia Due to Root Entry Zone Lipomatosis: 2-Dimensional Operative Video

Abstract

Cranial nerve lipomatosis is an extremely rare entity distinct from lipoma. Both entities share imaging features; however, in lipomatosis, adherence and infiltration of nerves is the major cause of symptoms and reason for increased postoperative morbidity.3-5. Considering its benign and in addition to the difficulty in achieving a total removal, surgical excision is not recommended. We present a 31-year-old woman with a 12-year history of paroxysmal lancinating rightsided facial pain and partial relief with medical treatment. The magnetic resonance imaging presents a lipomatous lesion adjacent to the root entry zone of the right trigeminal nerve. “The participants and any identifiable individuals consented to publication of his/her image.” We present, to our knowledge, the first documented video case of refractory trigeminal neuralgia due to trigeminal nerve lipomatosis treated with purely endoscopic surgical arachnoid lysis with satisfactory results and review of technical nuances.