Khan Fawad A, Manacheril Rinu, Ulep Robin, Martin Julie E, Chimakurthy Anil
The McCasland Family Comprehensive Headache Center, Department of Neurology, Ochsner Clinic Foundation, New Orleans, LA.
The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
Ochsner J. 2017 Fall;17(3):292-295.
Trigeminal trophic syndrome (TTS) is an uncommon disorder of the trigeminal nerve tract and trigeminal brainstem nucleus. The syndrome is characterized by a triad of unilateral crescentic ulcers with anesthesia and paresthesias of the involved trigeminal dermatomes.
A 24-year-old right-handed black female presented to our emergency department with a 4-week history of rapidly progressive painless desquamation/denudation of skin over her right face and scalp. Four weeks prior, she had been admitted to another institution for seizures and was diagnosed with seizures provoked by synthetic marijuana use. She was afebrile during her initial presentation at our institution. Dermatologic examination revealed denudation of the epidermis and partial dermis over the right frontal, parietal, and temporal scalp with associated alopecia.
To our knowledge, the association of disorders of the trigeminal nerve pathway, including TTS, with the use of synthetic marijuana has not been previously reported. The long-term neurologic effects of synthetic marijuana are difficult to predict, and the pathologic underpinnings of TTS are largely unknown. Further studies dedicated to exploring the underlying molecular and cellular mechanisms may translate into effective therapies and approaches to halt and reverse the process and prevent tissue destruction and cosmetic disfigurement.
三叉神经营养综合征（TTS）是一种罕见的三叉神经传导束和三叉神经脑干核疾病。该综合征的特征为三联征，即单侧新月形溃疡伴受累三叉神经皮节感觉缺失和感觉异常。
一名24岁右利手黑人女性因右脸和头皮皮肤快速进展性无痛性脱屑/剥脱4周就诊于我院急诊科。四周前，她因癫痫发作入住另一家机构，被诊断为使用合成大麻引发的癫痫发作。她在我院初诊时无发热。皮肤科检查发现右额、顶和颞部头皮表皮和部分真皮剥脱，伴有脱发。
据我们所知，包括TTS在内的三叉神经通路疾病与使用合成大麻之间的关联此前尚未见报道。合成大麻的长期神经学影响难以预测，且TTS的病理基础在很大程度上尚不清楚。致力于探索潜在分子和细胞机制的进一步研究可能转化为有效的治疗方法，以阻止和逆转这一过程，防止组织破坏和容貌毁损。
