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Vestibular and trigeminal schwannoma

Secondary hemifacial spasm due to vestibular schwannoma is very rare. A study by S Peker et al..^[1] was the first reported case of hemifacial spasm that responded to gamma knife radiosurgery in a patient with intracanalicular vestibular schwannoma. Both resolution of the spasm and control of tumor growth were achieved with a single session of gamma knife radiosurgery. Control of tumor growth was achieved and there were no changes in tumor volume at the last follow-up at 22 months. The hemifacial spasm resolved completely after one year. Surgical removal of the presumably causative mass lesion has been reported to be the only treatment in secondary hemifacial spasm.

Figura 1: Escwanoma del trigémino y maloclusión dental por Brandon Emilio Bertot et al..^[2]
The criticism that can be made of this statement is that in our case it is the masseter muscle that is involved, but this criticism is answered: if there is a hemifacial spasm due to vestibular scwannoma, then could a masticatory spasm due to trigeminal scwannoma occur? From a study by Ajay Agarwa ^[3] It seems that intracranial trigeminal schwannomas are rare tumors. Patients often present with symptoms of trigeminal nerve dysfunction, with facial pain being the most common symptom. MRI is the imaging modality of choice and is usually diagnostic in the appropriate clinical setting. Axial 3D CISS T2-weighted sequences are important for a correct evaluation of the cisternal segment of the nerve. They are usually hypointense on T1, hyperintense on T2 with accretion after gadolinium. But it cannot surprise us that cases like the one described by Brandon Emilio Bertot et al..^[2]in which a clinical case of a 16-year-old boy with atypical presentation of a large trigeminal schwannoma, dental malocclusion, painless and unilateral masticatory weakness is reported. The authors confirm that this case is the first documented case in which a trigeminal schwannoma has resulted in malocclusion; This is the 19th documented case of unilateral trigeminal motor neuropathy of any etiology.

↑ Peker S, Ozduman K, Kiliç T, Pamir MN, «Relief of hemifacial spasm after radiosurgery for intracanalicular vestibular schwannoma», in Minim Invasive Neurosurg, Georg Thieme Verlag, 2004, Stuttgart · New York».
DOI:10.1055/s-2004-818485
↑ ^2.0 ^2.1 Brandon Emilio Bertot, Melissa Lo Presti, Katie Stormes, Jeffrey S Raskin, Andrew Jea, Daniel Chelius, Sandi Lam. Trigeminal schwannoma presenting with malocclusion: A case report and review of the literature.Surg Neurol Int. 2020 Aug 8;11:230. doi: 10.25259/SNI_482_2019.eCollection 2020.
↑ Ajay Agarwal. Intracranial trigeminal schwannoma Ajay Agarwal. Neuroradiol J.2015 Feb;28(1):36-41. doi: 10.15274/NRJ-2014-10117.

[1] Peker S, Ozduman K, Kiliç T, Pamir MN, «Relief of hemifacial spasm after radiosurgery for intracanalicular vestibular schwannoma», in Minim Invasive Neurosurg, Georg Thieme Verlag, 2004, Stuttgart · New York».
DOI:10.1055/s-2004-818485

[:0-2] 2.0 ^2.1 Brandon Emilio Bertot, Melissa Lo Presti, Katie Stormes, Jeffrey S Raskin, Andrew Jea, Daniel Chelius, Sandi Lam. Trigeminal schwannoma presenting with malocclusion: A case report and review of the literature.Surg Neurol Int. 2020 Aug 8;11:230. doi: 10.25259/SNI_482_2019.eCollection 2020.

[3] Ajay Agarwal. Intracranial trigeminal schwannoma Ajay Agarwal. Neuroradiol J.2015 Feb;28(1):36-41. doi: 10.15274/NRJ-2014-10117.

[1]

[2]

[3]

@@ Line 1: / Line 1: @@
-=== Schwanoma vestibular y del trigémino ===
+=== Vestibular and trigeminal schwannoma ===
-El espasmo hemifacial secundario por schwannoma vestibular es muy raro. Un estudio de S Peker et al..<ref>{{cita libro
+Secondary hemifacial spasm due to vestibular schwannoma is very rare. A study by S Peker et al..<ref>{{cita libro
   | autore = Peker S
   | autore2 = Ozduman K
@@ Line 19: / Line 19: @@
   | LCCN =
   | OCLC =
-  }}</ref> fue el primer caso informado de espasmo hemifacial que respondió a la radiocirugía con bisturí de rayos gamma en un paciente con schwannoma vestibular intracanalicular. Tanto la resolución del espasmo como el control del crecimiento del tumor se lograron con una sola sesión de radiocirugía con bisturí de rayos gamma. Se logró el control del crecimiento tumoral y no hubo cambios en el volumen tumoral en el último seguimiento a los 22 meses. El espasmo hemifacial se resolvió completamente después de un año. Se ha informado que la extirpación quirúrgica de la lesión de masa presumiblemente causante es el único tratamiento en el espasmo hemifacial secundario.
+  }}</ref> was the first reported case of hemifacial spasm that responded to gamma knife radiosurgery in a patient with intracanalicular vestibular schwannoma. Both resolution of the spasm and control of tumor growth were achieved with a single session of gamma knife radiosurgery. Control of tumor growth was achieved and there were no changes in tumor volume at the last follow-up at 22 months. The hemifacial spasm resolved completely after one year. Surgical removal of the presumably causative mass lesion has been reported to be the only treatment in secondary hemifacial spasm.
 <blockquote>[[File:Scwannoma.jpeg|thumb|Figura 1: Escwanoma del trigémino y maloclusión dental por Brandon Emilio Bertot et al..<ref name=":0">Brandon Emilio Bertot, Melissa Lo Presti, Katie Stormes, Jeffrey S Raskin, Andrew Jea, Daniel Chelius, Sandi Lam. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7451153/#!po=12.5000 Trigeminal schwannoma presenting with malocclusion: A case report and review of the literature.]Surg Neurol Int. 2020 Aug 8;11:230. doi: 10.25259/SNI_482_2019.eCollection 2020.
-</ref>]]La crítica que se puede hacer a esta afirmación es que en nuestro caso es el músculo masetero el que está involucrado, pero esta crítica se responde: si hay un espasmo hemifacial por scwannoma vestibular, ¿podría entonces ocurrir un espasmo masticatorio por scwannoma trigeminal? De un estudio de Ajay Agarwa <ref>Ajay Agarwal. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4757116/ Intracranial trigeminal schwannoma]
+</ref>]]The criticism that can be made of this statement is that in our case it is the masseter muscle that is involved, but this criticism is answered: if there is a hemifacial spasm due to vestibular scwannoma, then could a masticatory spasm due to trigeminal scwannoma occur? From a study by Ajay Agarwa <ref>Ajay Agarwal. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4757116/ Intracranial trigeminal schwannoma]
 Ajay Agarwal. Neuroradiol J.2015 Feb;28(1):36-41.
-doi: 10.15274/NRJ-2014-10117.</ref> parece que los schwannomas trigeminales intracraneales son tumores raros. Los pacientes suelen presentar síntomas de disfunción del nervio trigémino, siendo el síntoma más común el dolor facial. La resonancia magnética es la modalidad de imagen de elección y suele ser diagnóstica en el entorno clínico adecuado. Las secuencias axiales 3D CISS ponderadas en T2 son importantes para una correcta evaluación del segmento cisternal del nervio. Suelen ser hipointensos en T1, hiperintensos en T2 con acreción tras gadolinio. Pero no nos puede sorprender que casos como el descrito por Brandon Emilio Bertot et al..<ref name=":0" />en el cual se reporta un caso clínico de un joven de 16 años con presentación atípica de un gran schwannoma del trigémino, maloclusión dentaria, debilidad masticatoria indolora y unilateral. Los autores confirman que este caso es el primero documentado en el que un schwannoma del trigémino ha resultado en maloclusión; es el 19º caso documentado de neuropatía motora unilateral del trigémino de cualquier etiología.
+doi: 10.15274/NRJ-2014-10117.</ref> It seems that intracranial trigeminal schwannomas are rare tumors. Patients often present with symptoms of trigeminal nerve dysfunction, with facial pain being the most common symptom. MRI is the imaging modality of choice and is usually diagnostic in the appropriate clinical setting. Axial 3D CISS T2-weighted sequences are important for a correct evaluation of the cisternal segment of the nerve. They are usually hypointense on T1, hyperintense on T2 with accretion after gadolinium. But it cannot surprise us that cases like the one described by Brandon Emilio Bertot et al..<ref name=":0" />in which a clinical case of a 16-year-old boy with atypical presentation of a large trigeminal schwannoma, dental malocclusion, painless and unilateral masticatory weakness is reported. The authors confirm that this case is the first documented case in which a trigeminal schwannoma has resulted in malocclusion; This is the 19th documented case of unilateral trigeminal motor neuropathy of any etiology.
 </blockquote>