870 - Trigeminal Neuralgia in the Setting of Scuba Diving : A Case Report

Thursday, February 22, 2024

5:00 PM – 6:30 PM EDT

Presenting Author(s)

DW

Derek Wang, MS

Medical student
Western University of Health Sciences, College of Osteopathic Medicine of the Pacific
S PASADENA, California, United States

Co-Author(s)

KL

Kyaw Lin, DO

Physician
Touro university
Pleasant Hill, California, United States

Case Diagnosis: Trigeminal neuralgia

Case Description: A 47-year-old male with a history of coronary artery disease (CAD) status post stent placement, diabetes, asthma, and allergic rhinitis presents to the pain management clinic with mild right-sided neck pain and intermittent right facial pain. The patient had sought medical attention for neck pain, which had improved over time, but was more concerned about the intermittent right facial pain involving the distribution of the right trigeminal nerve branches V2 and V3. He states the pain happens in brief 30-second episodes and is triggered when brushing his teeth or washing his face. The patient's facial pain was accompanied by a recent history of scuba diving during which he experienced neurological deficits consistent with decompression sickness (DCS) due to his quick ascent from diving. He denied any facial trauma during scuba diving and complained of maxillary tooth pain. We referred him to a neurologist and discussed preventive measures.

Discussions: The patient's history of quick ascent and DCS suggests that the patient likely experienced sinus barotrauma. Given the patient's history of asthma and allergic rhinitis, he may be predisposed to sinus obstruction. The anatomic location of the V2 predisposes it to barotrauma since it travels within the bony walls of air-filled cavities. He could have experienced compression of the trigeminal nerve which would explain the neuralgia and maxillary tooth pain the patient is experiencing.

Conclusions: Trigeminal neuralgia can manifest in scuba divers potentially due to barotrauma by irritating or damaging the trigeminal nerve. As scuba diving continues to grow in popularity, healthcare providers and divers alike must remain informed about the potential neurological consequences. Further research is needed to explore potential connections between scuba diving and trigeminal neuralgia and to optimize treatment strategies for patients.