Trigeminal Trophic Syndrome

Oral Diseases, 2007

Trigeminal trophic syndrome is an uncommon clinical entity in which cutaneous trophic ulceration develops with continuous manipulation of trigeminal dermatomes. Patients spontaneously refer picking, rubbing and/or scratching at the affected areas because of hypo-anaesthesia, paraesthesia and/or pain following damage of the sensory trigeminal fibres or nuclei. We herein describe a patient who developed the syndrome as a sequela of brain stem infarction. Diagnosis by scrape cytology in ruling-out basal cell carcinoma and other ulcerative skin diseases is discussed and the importance of neurological examination in disclosing hemi-anaesthesia of trigeminal dermatome(s) is emphasized.

Dermatologic Surgery, 2004

BACKGROUND. Trigeminal trophic syndrome is a unilateral, frequently crescent-shaped neurotrophic ulceration of the face occurring after injury to the trigeminal nerve. The appearance of the ulcers resembles other disease entities such as granulomatous disease, neoplasm, vasculitis, infection, and factitial dermatitis. OBJECTIVES. The objectives of this study are to increase awareness of this disorder and to emphasize the importance of eliciting a thorough neurologic history when evaluating facial ulcerations. METHODS. Four cases are reported and, using MEDLINE, the English and non-English literature from 1982 to 2002 is reviewed. RESULTS. Including this report, there have been 60 cases of trigeminal trophic syndrome reported from 1982 to 2002. The

Journal of Craniofacial Surgery, 2013

Numbness and ulceration of the face, particularly erosion of ala of the nose, sometimes occur after sensory denervation in the territory of the divisions of the trigeminal nerve. The incidence is uncertain and usually follows surgical treatments for trigeminal neuralgia. Such condition is known as trigeminal trophic syndrome (TTS), although some authors believe it to be a special form of dermatitis artefacta. Trigeminal trophic syndrome most commonly affects adults, after iatrogenic, vascular, viral, or neoplastic damage to the trigeminal nerve. We present a rare case of TTS in a 32-year-old woman who was referred to us with progressive numbness in the right upper and lower lip region.

Archives of Facial Plastic Surgery, 2004

Background: Nasal ulcerations have many causes. Ulcerations that are self-induced are difficult to diagnose and treat. Two rare conditions with self-induced nasal ulceration are trigeminal trophic syndrome (TTS) and factitious disorder (FD). Trigeminal trophic syndrome is characterized by trigeminal anesthesia, nasal alar ulceration, and facial paresthesia. Appearance of the nasal ulcer after trigeminal ablation for neuralgia is diagnostic. Self-induced nasal lesions that occur in FD are primarily distinguished from those in TTS by the presence of normal trigeminal nerve function and frequent patient denial of lesion manipulation. Objectives: To increase physician awareness of the disorders leading to self-induced nasal ulceration and to discuss management issues in our patient series. Design: A retrospective review of 7 cases in which the patients presented for reconstructive consultation between March 1985 and October 1997 and were found to have self-induced nasal ulcerations. Setting: Tertiary university medical center. Results: Five patients were identified with TTS and underwent nasal reconstruction an average of 43 months

WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES, 2021

Trigeminal neuralgia (TN) is a debilitating disorder that presents with a sudden onset of severe, unilateral, paroxysmal, and lancinating pain in one or more of the distributions of the trigeminal nerve. Trigeminal neuralgia affects the trigeminal nerve, fifth most developed and extensive cranial nerve, with a broad distribution territory. Its name - “trigeminal” - is derived from the fact that each nerve, one on each side of the pons, has three major branches: the ophthalmic nerve (V1), the maxillary nerve (V2) and the mandibular nerve (V3). The ophthalmic and maxillary nerves are purely sensory. The mandibular nerve has both sensory and motor functions.[1] It is a mixed nerve conducting sensitive and motor somatic fibers to the face, and is ideally responsible for all its sensitive innervation (touch, pain, temperature and propioception) together with the motor innervation of the mastication apparatus. Though it has been known by various names in the literature such as tic douloureux, trifacial neuralgia, fothergill’s disease (named after john fothergill), the currently accepted terminology is trigeminal neuralgia.[2]

International journal of oral and maxillofacial surgery, 2012

This study describes the management of 216 patients with post-traumatic iatrogenic lingual nerve injuries (LNIs; n=93) and inferior alveolar nerve injuries (IANI; n=123). At initial consultation, 6% IANI and 2% LNI patients had undergone significant resolution requiring no further reviews. Reassurance and counselling was adequate management for 51% IANI and 55% LNI patients. Systemic or topical medication was offered as pain relief to 5% of patients. Additional cognitive behaviour therapy (CBT) was offered to 8% of patients. Topical 5% lidocaine patches reduced pain and allodynia in 7% of IANI patients, most often used without any other form of management. A small percentage of IANI patients (4%) received a combination of therapies involving CBT, surgery, medication and 5% lidocaine patches. Exploratory surgery improved symptoms and reduced neuropathic area in 18 LNI and 15 IANI patients resulting in improved quality of life. In conclusion, the authors suggest a more diverse and per...

Cephalalgia, 2005

Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) represents a brief headache syndrome first described in 1989. Its name summarizes the clinical features: short-lasting, unilateral, neuralgiform headache attacks, with conjunctival injection, tearing and rhinorrhoea (1).

2012

Trigeminal nerve injury is the most problematic consequence of dental surgical procedures with major medico-legal implications. This study reports the signs and symptoms that are the features of trigeminal nerve injuries caused by mandibular third molar (M3M) surgery. 120 patients with nerve injury following M3M surgery were assessed. All data were analysed using the SPSS statistical programme and Microsoft Excel. 53 (44.2%) inferior alveolar nerve (IAN) injury cases and 67 (55.8%) lingual nerve injury (LNI) cases were caused by third molar surgery (TMS). Neuropathy was demonstrable in all patients with varying degrees of paraesthesia, dysaesthesia (in the form of burning pain), allodynia and hyperalgesia. Pain was one of the presenting signs and symptoms in 70% of all cases. Significantly more females had IAN injuries and LNIs (p<0.05). The mean ages of the two groups of patients were similar. Speech and eating were significantly more problematic for patients with LNIs. In conclusion, chronic pain is often a symptom after TMS-related nerve injury, resulting in significant functional problems. Better dissemination of good practice in TMS will significantly minimize these complex nerve injuries and prevent unnecessary suffering.Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Archives of Physical Medicine and Rehabilitation, 2000

Trigeminal neuropathy resulting from local anesthetic injection has not been reported in the literature. We present a 49-year-old man with 8 months of unilateral facial sensorimotor deficits in the distribution of the trigeminal nerve, following a local anesthetic injection. His medical history was significant for resection of an ipsilateral tongue carcinoma 4 years earlier with only postsurgical dysarthria and no other neurologic deficits. Magnetic resonance imaging of the head and face showed postsurgical changes and ipsilateral atrophic muscles of mastication without evidence of infection or tumor recurrence. Electrodiagnostic evaluation revealed prolonged ipsilateral R1, ipsilateral and contralateral R2 responses of the blink reflex, and neurogenic electromyographic changes in ipsilateral masseter and temporalis muscles, consistent with ipsilateral trigeminal nerve injury. Although trigeminal neuropathies from various etiologies have been reported, this unique case offers another etiology to consider: iatrogenic trigeminal neuropathy secondary to local anesthetic injection.