Trigeminal Neuralgia and Charcot-Marie-Tooth Disease: An Intriguing Association. Lessons From a Large Family Case Report and Review of Literature

Headache. 2019 Jul;59(7):1074-1079. doi: 10.1111/head.13576. Epub 2019 Jun 20.

Abstract

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.

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Charcot-Marie-Tooth disease; MPZ mutation; P0 mutation; familial trigeminal neuralgia; trigeminal neuralgia.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Charcot-Marie-Tooth Disease* / epidemiology
  • Charcot-Marie-Tooth Disease* / genetics
  • Charcot-Marie-Tooth Disease* / physiopathology
  • Comorbidity
  • Female
  • Humans
  • Myelin P0 Protein* / genetics
  • Pedigree
  • Trigeminal Neuralgia* / epidemiology
  • Trigeminal Neuralgia* / genetics
  • Trigeminal Neuralgia* / physiopathology

Substances

  • MPZ protein, human
  • Myelin P0 Protein