Department of Neurology, Rouen University Hospital, Rouen, France.
Headache. 2019 Jul;59(7):1074-1079. doi: 10.1111/head.13576. Epub 2019 Jun 20.
We report a case of familial trigeminal neuralgia (TN) and Charcot-Marie-Tooth disease (CMT) caused by an identified MPZ mutation with a review of previous cases described in the literature.
The association of TN in CMT patients has previously been reported in a few cases. The pathophysiological link can be detailed with recent use of genetic analysis in CMT.
We report a large family including 7 members affected by CMT, 4 of whom also presented with TN. We then performed a literature review of literature by search of Pubmed from 1950 to September 2018, using the search terms "trigeminal neuralgia" and "Charcot-Marie-Tooth" and the references of relevant articles.
Overall, we found 29 previously published TN cases in 12 CMT families. Among them, only 7 families (69%) included several affected members, suggesting that not all mutations involved in CMT predispose to TN. TN in this context seems to present with specific characteristics, including earlier age of onset, bilateral presentation, and poor tolerance to preventive treatments with gait disturbance exacerbated by the underlying neuropathy.
This report of familial TN in CMT with identified MPZ mutation highlighted specific characteristics of this association. Considered as a rare association in the literature, it may be underestimated and the clinician should be aware of its specific pattern, including earlier age of onset, bilateral presentation, and poor tolerance to preventive treatments.
我们报告了一例家族性三叉神经痛(TN)和 Charcot-Marie-Tooth 病(CMT),由已识别的 MPZ 突变引起,并回顾了文献中以前描述的病例。
CMT 患者的 TN 以前在少数情况下有报道。随着 CMT 中遗传分析的最新应用,可以详细了解其病理生理联系。
我们报告了一个包括 7 名受 CMT 影响的成员的大家庭,其中 4 名也患有 TN。然后,我们通过在 1950 年至 2018 年 9 月期间在 Pubmed 上搜索“三叉神经痛”和“Charcot-Marie-Tooth”以及相关文章的参考文献,进行了文献综述。
总体而言,我们在 12 个 CMT 家族中发现了 29 例以前发表的 TN 病例。其中,只有 7 个家族(69%)包括多个受影响的成员,这表明并非所有涉及 CMT 的突变都易患 TN。在这种情况下,TN 似乎具有特定的特征,包括发病年龄更早、双侧表现和对预防性治疗的耐受性差,潜在的神经病变会加重步态障碍。
本报告中 CMT 伴已识别的 MPZ 突变的家族性 TN 强调了这种关联的特定特征。考虑到文献中这种关联罕见,可能被低估,临床医生应了解其特定模式,包括发病年龄更早、双侧表现和对预防性治疗的耐受性差。