• Annals of Clinical Neurophysiology
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• v.7 no.1
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• pp.43-45
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• 2005

Trigeminal sensory neuropathy is a clinical diagnosis in which the main feature is facial numbness limited to territory of one or more sensory branches of the trigeminal nerve. We describe a 46-year-old woman who presented with left facial numbness in the territories of maxillary nerve and mandibular nerve. MRI disclosed a lesion in left trigeminal nerve root entry zone. In Blink test stimulating infraorbital foramen, ipsilateral R1 was delayed compared with contralateral R1. Lesion in pons or medulla can present as trigeminal sensory neuropathy.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.640-651
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• 2022

Clinical studies on neuromodulation intervention for trigeminal neuralgia have not yet shown promising results. This might be due to the fact that the pathophysiology of chronic trigeminal neuropathy is not yet fully understood. Chronic trigeminal neuropathy includes trigeminal autonomic neuropathy, painful trigeminal neuropathy, and persistent idiopathic facial pain. This disorder is caused by complex abnormalities in the pain processing system, which is comprised of the affective, emotional, and sensory components, rather than mere abnormal sensation. Therefore, integrative understanding of the pain system is necessary for appropriate neuromodulation of chronic trigeminal neuropathy. The possible neuromodulation targets that participate in complex pain processing are as follows : the ventral posterior medial nucleus, periaqueductal gray, motor cortex, nucleus accumbens, subthalamic nucleus, globus pallidus internus, anterior cingulate cortex, hypothalamus, sphenopalatine ganglion, and occipital nerve. In conclusion, neuromodulation interventions for trigeminal neuralgia is yet to be elucidated; future advancements in this area are required.

• Journal of Oral Medicine and Pain
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• v.45 no.2
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• pp.34-38
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• 2020

Multiple myeloma is malignant neoplasm of plasma cells. Mandible lesions are rarely the first symptoms of multiple myeloma. While sensory dysfunction and pain are the main symptoms of traumatic trigeminal neuropathy, the same oral symptoms can appear in cases of multiple myeloma with developed mandible lesions. In addition, if the radiological osteoporosis or lytic lesion is seen in older patients, further examination is required to find the cause of the symptoms. In this paper, we present a case that was tentatively diagnosed as traumatic trigeminal neuropathy after left third molar extraction, but later confirmed as multiple myeloma.

• Journal of Oral Medicine and Pain
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• v.47 no.4
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• pp.217-221
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• 2022

Neurogenic muscular atrophy is muscle wasting and weakness caused by trauma or disease of the nerve that innervates the muscle. We describe a case of unilateral trigeminal neuropathy and neurogenic muscular atrophy of the masticatory muscle caused by a tumor in the foramen ovale. A 59-year-old man visited our clinic complaining of difficulty in right-sided mastication. There were no evident clinical signs and symptoms of temporomandibular disorder. However, severe atrophy of the right masseter and temporalis muscles and hypesthesia of the right side mandibular nerve area were confirmed. Through T1 and T2 signals on magnetic resonance imaging (MRI), a mass suspected of a neurogenic tumor was observed in the foramen ovale and cavernous sinus. Severe atrophy of all masticatory muscles on the right side was observed. This rare case shows trigeminal neuropathy caused by a tumor around the foramen ovale and atrophy of the ipsilateral masticatory muscles. For an accurate diagnosis, it is essential to identify the underlying cause of muscle atrophy with neurologic symptoms present. This can be done through a more detailed clinical examination, including sensory testing and brain MRI, and consider a referral to neurology or neurosurgery for the differential diagnosis of the intracranial disorder.