Uesugi Seiji, Nakayama Hisato, Higashi Mayu, Suzuki Michiyasu
Department of Neurosurgery, Saiseikai Shimonoseki General Hospital, Shimonoseki, Yamaguchi, Japan.
Brain Nerve. 2010 Sep;62(9):987-90.
We present a case of isolated trigeminal neuropathy involved with motor dysfunction due to a small infarction in the pontine tegmentum. A 70-year-old man presented with sudden numbness around the left mouth accompanied by maxillary pain. Neurological examinations revealed jaw deviation to the left when opening the mouth, but no other abnormal findings including those of the cranial nerves were detected. X-rays indicated hypomobility of the left temporomandibular joint, and diffusion-weighted magnetic resonance imaging (MRI) revealed a small infarction in the left pontine tegmentum. Unilateral limitation of the temporomandibular joint movement, numbness, and pain in the territory of the left trigeminal nerve resolved within 2 months. This case suggests that a small infarction in the pontine tegmentum can simultaneously cause trigeminal neuralgia and masticatory muscle weakness with no other symptoms and signs. MRI, especially diffusion-weighted imaging, should be considered for patients with isolated trigeminal neuropathy.
我们报告一例因脑桥被盖部小梗死导致的孤立性三叉神经病变伴运动功能障碍。一名70岁男性，出现左口角周围突发麻木并伴有上颌部疼痛。神经系统检查发现张口时下颌向左偏斜，但未检测到包括脑神经在内的其他异常表现。X线显示左颞下颌关节活动度降低，弥散加权磁共振成像（MRI）显示左脑桥被盖部有小梗死灶。左颞下颌关节运动单侧受限、左三叉神经分布区域麻木和疼痛在2个月内缓解。该病例提示脑桥被盖部小梗死可同时引起三叉神经痛和咀嚼肌无力，而无其他症状和体征。对于孤立性三叉神经病变患者，应考虑进行MRI检查，尤其是弥散加权成像。
