Benign Trigeminal Sensory Neuropathy
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A syndrome of isolated (though occasionally, bilateral) facial numbness, gradual in onset,
which may involve a single division of the
Trigeminal Nerve or all 3 divisions.

Some cases are idiopathic but many underlying diseases, especially connective tissue diseases, can cause
Trigeminal Sensory Neuropathy (TSN).
Last Updated 13th June 2017
Useful Articles:

BMJ 1970.  Trigeminal Sensory Neuropathy

J Oral Maxillofac Surg 2001.  Acyclovir Treatment in 2 Patients With Benign Trigeminal Sensory Neuropathy

Arq Neuropsiquiatr 2007.  Trigeminal sensory neuropathy & facial contact dermatitis due to Anthurium sp

Oral Diseases 2007.  Trigeminal Neuropathy

Cephalalgia 2011.  Numbness Matters – A Clinical Review of Trigeminal Neuropathy

Eastman Dental Hospital Facial Pain Team 2013.  Trigeminal Neuropathic Pain
When an apparent cause is not detected, the disease is defined as Idiopathic Trigeminal Sensory Neuropathy
(
ITSN), which is usually transient.

ITSN is always considered an exclusion diagnosis, so that various systemic, intra-cranial (within the skull) and
extra-cranial (outside the skull) disorders must first be eliminated.

Classically, involvement of the
Trigeminal Nerve is related to demyelinating diseases (such as Multiple Sclerosis),
the presence of tumours,
vascular diseases, trauma, local injections, terminal kidney disease, infections, drugs
and
connective tissue diseases.

Of this group of disorders,
Multiple Sclerosis and connective tissue diseases, as well as ITSN, are of particular
importance.
Trigeminal neuropathy most commonly manifests as numbness in the face or mucous membranes, sometimes in
association with
masticatory weakness, paresthesiæ, and / or pain.

Although many patients may be eventually labeled as having
idiopathic TNO, the diverse and potentially
life-threatening etiologies that may underlie
TNO demand a complete evaluation. A patient labelled as having
idiopathic TNO deserves a high index of suspicion for missed diagnoses, which may only reveal themselves with
time.

Treatment should be aimed at targeting the underlying patho-physiology, if identified and treatment of
complications, which may be uncomfortable, disabling, or potentially life-threatening to the patient.
Treatment Approach to Trigeminal Neuropathy