1/8. diagnosis of acromegaly in orofacial pain: two case reports.acromegaly is an uncommon condition, with an annual incidence in the UK of three per million. The gradual onset of the clinical features mean that often friends and relatives are unaware of the underlying pathology. In view of the morbidity, and indeed mortality, arising from undiagnosed cases, general dental practitioners and other healthcare workers should routinely take note of systemic as well as intra-oral changes occurring in their patients when seen on review. The association of paraesthesia, anaesthesia and pain with acromegaly is well documented. However, there appear to be few reports linking acromegaly with orofacial pain or dysaesthesia. This paper describes two such cases.- - - - - - - - - - ranking = 1keywords = paraesthesia (Clic here for more details about this article) |
2/8. Dracula's teeth syndrome.OBJECTIVE: To describe a patient with facial pain, ipsilateral facial dystonia, and phantom supernumerary teeth, beginning after resection of hypertrophic gums. She had familial sensorineural deafness. BACKGROUND: Atypical cranial dystonia subsequent to dental procedures is associated with facial pain, dysesthesias, or phantom phenomena, but not with phantom supernumerary teeth. patients with migraine are susceptible to experience cephalic phantom phenomena after dental procedures. Wynne syndrome is a hereditary autosomal dominant disorder characterized by congenital sensorineural deafness and supernumerary teeth. methods: Clinical examination, computerized tomography of paranasal sinuses and facial bones, magnetic resonance imaging of the brain, cranial electrophysiological testing, and electroencephalogram. RESULTS: A 52-year-old woman with history of migraine without aura for 40 years exhibited focal right facial involuntary tonic contracture accompanying chronic severe pain over the same area after gum resection. She reported a daily sensation of having two extra upper canine teeth pressing on her tongue, simulating vampire's ("Dracula's") teeth. She had high-frequency bilateral sensorineural deafness. Her computerized tomography studies, brain magnetic resonance imaging, and cranial electrophysiological testing were normal. CONCLUSION: This patient with chronic migraine had atypical cranial dystonia beginning after a dental procedure. Her dystonia was complicated by the unusual phenomenon of phantom supernumerary teeth. This condition may be misdiagnosed as atypical or psychogenic facial pain when facial dystonia is localized or subtle and is, therefore, confused with an idiosyncratic gesture or habitual spasm. Her signs and symptoms are reminiscent of Wynne syndrome.- - - - - - - - - - ranking = 167.50733622048keywords = dysesthesia (Clic here for more details about this article) |
3/8. trochlear nerve neuroma manifested with intractable atypical facial pain: case report.OBJECTIVE AND IMPORTANCE: trochlear nerve neuromas are extremely rare. Seventeen surgical cases of this pathological condition have been reported in the English literature. The presented case is distinct from previous reports. CLINICAL PRESENTATION: A 26-year-old woman presented with atypical facial pain. The neurological examination results were normal. magnetic resonance imaging revealed a left parasellar mass. INTERVENTION: A left pterional craniotomy was performed, providing access to the left parasellar area. After incision of the tentorial edge, the tumor was observed to originate from the short segment of the trochlear nerve that runs between the tentorial leaves. The neuroma was totally removed. CONCLUSION: The facial pain resolved immediately after surgery. Although facial dysesthesias have been noted among patients with trochlear nerve neuromas, here the atypical facial pain was the only clinical manifestation. In all previously reported cases, neuromas originated from the cisternal segment of the trochlear nerve (always before the site of nerve entrance into the tentorial leaves) and expanded mainly into the prepontine and interpeduncular cisterns. Subtemporal and suboccipital approaches were used. In this case, the tumor arose from the short segment of the nerve running between the tentorial leaves. The tumor did not extend either into the ambient cistern or into the cavernous sinus but did involve the parasellar area. A pterional approach was appropriate for tumor removal. A trochlear nerve neuroma should be considered as a potential cause of atypical facial pain.- - - - - - - - - - ranking = 167.50733622048keywords = dysesthesia (Clic here for more details about this article) |
4/8. Sympathetic activity-mediated neuropathic facial pain following simple tooth extraction: a case report.This is a report of a case of sympathetic activity-mediated neuropathic facial pain induced by a traumatic trigeminal nerve injury and by varicella zoster virus infection, following a simple tooth extraction. The patient had undergone extraction of the right lower third molar at a local dental clinic, and soon after the tooth extraction, she became aware of spontaneous pain in the right ear, right temporal region, and in the tooth socket. At our initial examination 30 days after the tooth extraction, the healing of the tooth socket was normal; however, the patient had a tingling and burning sensation (dysesthesia) and spontaneous pain of the right lower lip and the right temporal region, both of which were exacerbated by non-noxious stimuli (allodynia). The patient also showed paralysis of the marginal mandibular branch of the facial nerve, taste dysfunction, and increased varicella zoster serum titers. A diagnostic stellate ganglion block (SGB) 45 days after the tooth extraction using one percent lidocaine markedly alleviated the dysesthesia and allodynia. These symptoms are characteristic of neuropathic pain with sympathetic interaction. The patient was successfully treated with SGB and a tricyclic antidepressant.- - - - - - - - - - ranking = 335.01467244095keywords = dysesthesia (Clic here for more details about this article) |
5/8. Idiopathic trigeminal neuralgia complicated by lingual nerve dysesthesia.The treatment of facial pain disorders has become a multifaceted discipline that involves numerous scientific fields. Diagnostic and treatment modalities may be beneficial to the patient but at times may also complicate the problem and compromise the outcome. We present an interesting case of left trigeminal neuralgia complicated by unassociated lingual nerve dysesthesia.- - - - - - - - - - ranking = 837.53668110238keywords = dysesthesia (Clic here for more details about this article) |
6/8. Facial numbness and dysesthesia. New features of carotid artery dissection.Facial numbness and dysesthesia have not been emphasized as presenting features in spontaneous internal carotid artery dissection. Progressive facial pain, accompanied by oculosympathetic paresis, altered taste, and facial numbness suggest the possibility of basal skull neoplasm. We describe a patient, with previously undiscovered fibromuscular dysplasia, who presented with severe neck and face pain, dysgeusia, oculosympathetic paresis, and markedly reduced facial sensation due to a spontaneous vascular dissection. Altered facial sensation should now be included in the symptomatology of internal carotid artery dissection.- - - - - - - - - - ranking = 837.53668110238keywords = dysesthesia (Clic here for more details about this article) |
7/8. Traumatic dysesthesia of the trigeminal nerve.Traumatic injury to the peripheral nerves often results in persistent discomfort. substance p has been implicated as a mediator of pain, and depletion of this neurotransmitter has been shown to reduce pain. Subjects suffering from traumatic dysesthesia of the trigeminal nerve were treated with capsaicin, a substance p depleter with significant long-term effects. This form of therapy may be used individually or in combination with other pharmacologic interventions in the treatment of traumatic trigeminal dysesthesia.- - - - - - - - - - ranking = 1005.0440173229keywords = dysesthesia (Clic here for more details about this article) |
8/8. adult Chiari malformation with headache and trigeminal dysesthesia.Arriving at a correct diagnosis in some cases of facial pain and headache can test the time, patience, and diagnostic skills of any clinician. When the symptoms are diffuse with few localizing signs, it is easy to attribute pain to a functional origin. The case described underlines the importance of careful clinical examination and the use of magnetic resonance imaging, which proved the only positive diagnostic aid in this instance. The value of magnetic resonance imaging in redefining Chiari malformations is discussed and the question of appropriate interpretation of findings aired.- - - - - - - - - - ranking = 670.0293448819keywords = dysesthesia (Clic here for more details about this article) |