Galán Gil Sónnica, Peñarrocha Diago Maria, Peñarrocha Diago Miguel
Valencia University Medical and Dental School, Spain.
Med Oral Patol Oral Cir Bucal. 2008 Oct 1;13(10):E616-21.
Malignant mental neuropathy (MMN) is a neurological manifestation of cancer, characterized by the presence of hypoesthesia or anesthesia restricted to the territory of the mental branch of the mandibular nerve. A systematic review of the literature has been made on MMN, analyzing the etiology, pathogeny, clinical characteristics, complementary tests and the prognosis. Sixteen studies, providing 136 cases were selected. Breast cancer and lymphomas were the most frequently associated malignant diseases. The most frequent pathogenic mechanisms producing neurological involvement were: peripherally, mandibular lesions; and centrally, tumors at the base of the cranium. Regarding clinical characteristics, manifestation of MMN was the primary symptom of malignant disease in 27.7% of cases, and a first symptom of recurrence in 37.7%. The group of selected studies included 50 orthopantomographs, 9 mandibular computed tomographies and 50 radiographic examinations of the cranial region. The most affected region was the mandible. The appearance of MMN is an ominous prognosis for the progression of the disease, with a mortality of 78.5% within a mean of 6.9 months.
恶性颏神经病变(MMN)是癌症的一种神经学表现,其特征为仅在下颌神经颏支分布区域出现感觉减退或感觉缺失。我们对MMN相关文献进行了系统综述,分析了其病因、发病机制、临床特征、辅助检查及预后。共选取了16项研究,提供了136个病例。乳腺癌和淋巴瘤是最常伴发的恶性疾病。导致神经受累的最常见致病机制为:外周方面,下颌病变;中枢方面,颅底肿瘤。关于临床特征,MMN表现为27.7%的病例中恶性疾病的首发症状,以及37.7%的病例中复发的首发症状。所选研究组包括50张曲面断层片、9次下颌计算机断层扫描和50次颅骨区域的影像学检查。受累最严重的区域是下颌骨。MMN的出现对疾病进展而言预后不佳,平均6.9个月内死亡率为78.5%。