A case of eye pain successfully treated with microvascular decompression

Abstract

We report here a case of eye pain treated with microvascular decompression (MVD). A 42-year-old man had experienced left eye pain with conjunctival injection and tearing for six years. On the basis of his symptoms, we diagnosed him as having first division trigeminal neuralgia or short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT). Magnetic resonance cisternography showed that the left trigeminal nerve was in contact with and distorted by a blood vessel. Therefore, MVD was performed and the offending vessel was found to be the petrosal vein. The eye pain disappeared immediately after MVD. It is difficult to distinguish first division trigeminal neuralgia from SUNCT simply based on symptoms. The eye pain was definitively diagnosed as first division trigeminal neuralgia. Careful diagnosis is required to distinguish classical trigeminal neuralgia from SUNCT.