Longstanding trigeminal sensory neuropathy of nontraumatic cause

Objective. Trigeminal sensory neuropathy is an uncommon but often significa nt orofacial symptom. There are few detailed descriptions of the problem in the dental literature. The aim of this study was to evaluate the clinical presentation and management of a cohort of patients presenting with anesthe sia/paresthesia affecting one or more divisions of the trigeminal nerve unr elated to any identifiable traumatic cause. Study design. Nine patients with trigeminal neuropathy were examined. Each patient underwent a standard protocol of examination and hematologic, serol ogic, radiologic, and histopathologic investigations, as appropriate. Results. Trigeminal neuropathy was found to be secondary to distant maligna ncy in 4 patients and to connective tissue disease in 2 patients. In each o f 3 other patients, there was no obvious cause for the neuropathy. Patients with malignancy as the cause of their neuropathy tended to have involvemen t of more than one division of the trigeminal nerve and/or other neurologic features. Conclusions. Trigeminal sensory neuropathy may herald underlying distant ma lignancy or connective tissue disease. Anesthesia and paresthesia of the or ofacial region are therefore serious clinical symptoms that must be careful ly investigated before a diagnosis of idiopathic disease is made.