Ns. Litofsky et Ca. Megerian, Facial canal decompression leads to recovery of combined facial nerve paresis and trigeminal sensory neuropathy - Case report, SURG NEUROL, 51(2), 1999, pp. 198-201
BACKGROUND
Trigeminal sensory neuropathy is often associated with facial idiopathic ne
rve paralysis (Bell's palsy). Although a cranial nerve viral polyneuropathy
has been proposed as the usual cause, in many instances the etiology remai
ns unclear. This case report of recovery of both trigeminal and facial neur
opathy after surgical decompression of the facial nerve suggests an anatomi
c link.
METHODS
A case of a 39-year-old woman presenting with recurrent unilateral facial p
aralysis is summarized. Her fifth episode, which did not spontaneously reco
ver, was associated with retroorbital and maxillary pain as well as sensory
loss in the trigeminal distribution.
RESULTS
A middle cranial fossa approach for decompression of the lateral internal a
uditory canal, labyrinthine segment of the facial nerve and the geniculate
ganglion was performed. The patient's pain and numbness resolved immediatel
y postoperatively, and the facial paralysis improved markedly.
CONCLUSION
This result implicates a trigeminal-facial reflex as hypothesized by others
. It suggests that decompression of the facial nerve can lead to improvemen
t in motor and sensory function as well as relief of pain in some patients
with combined trigeminal and facial nerve dysfunction. (C) 1999 by Elsevier
Science Inc.