Longstanding trigeminal sensory neuropathy of nontraumatic cause.
OBJECTIVE
Trigeminal sensory neuropathy is an uncommon but often significant orofacial symptom. There are few detailed descriptions of the problem in the dental literature. The aim of this study was to evaluate the clinical presentation and management of a cohort of patients presenting with anesthesia/paresthesia affecting one or more divisions of the trigeminal nerve unrelated to any identifiable traumatic cause.


METHODS
Nine patients with trigeminal neuropathy were examined. Each patient underwent a standard protocol of examination and hematologic, serologic, radiologic, and histopathologic investigations, as appropriate.


RESULTS
Trigeminal neuropathy was found to be secondary to distant malignancy in 4 patients and to connective tissue disease in 2 patients. In each of 3 other patients, there was no obvious cause for the neuropathy. Patients with malignancy as the cause of their neuropathy tended to have involvement of more than one division of the trigeminal nerve and/or other neurologic features.


CONCLUSIONS
Trigeminal sensory neuropathy may herald underlying distant malignancy or connective tissue disease. Anesthesia and paresthesia of the orofacial region are therefore serious clinical symptoms that must be carefully investigated before a diagnosis of idiopathic disease is made.
Shotts
R H
RH
Department of Oral Medicine, Eastman Dental Institute of Oral Health Care Sciences, University of London, United Kingdom.
Porter
S R
SR
Kumar
N
N
Scully
C
C
D000230:Adenocarcinoma / Q000556:secondary; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology; D002277:Carcinoma / Q000556:secondary; D002528:Cerebellar Neoplasms / Q000473:pathology; D002908:Chronic Disease; D003240:Connective Tissue Diseases / Q000150:complications; D003389:Cranial Nerve Diseases / Q000209:etiology*; D005260:Female; D005909:Glioblastoma / Q000556:secondary; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000209:etiology*; D011471:Prostatic Neoplasms / Q000473:pathology; D012189:Retrospective Studies; D014276:Trigeminal Nerve