|Benign Trigeminal Sensory Neuropathy
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
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
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
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