Characteristic development of GABAergic transmission in the mouse spinal cord

Abstract

Background and objective: Isolated cranial nerve palsies are often attributed to lesions of the respective nerves. Small lesions of the brainstem can affect the trigeminal nerve only. A few cases of isolated trigeminal sensory change have been reported previously, but trigeminal sensory neuropathy has been rarely reported as a manifestation of pontine infarction. Patient and methods: A 77-year old female patient who had a history of hypertension and hyperlipidemia admitted with sudden Left perioral numbness. Two days prior to admission, she complained of numbness on the left perioral area. On neurological examination, pain and light touch sensations were decreased in the left V2 and V3 area. Results: Brain magnetic resonance imaging showed hyperintensity on left middle cerebellar peduncle in DWI & T2WI. No blink reflex potentials were recorded on the ipsilateral R1, R2 and contralateral R2 on stimulation of the left supraorbital nerve, while normal R1, R2 and contralateral R2 responses on the right side. Left Jaw jerk reflex were absent on masseter muscle. Conclusion: These clinical and electrophysiologic findings of abnormal blink reflex, left V2 and V3 area sensory change and an absence of left jaw jerk responses supports that hypothesis that the lesion may involve the whole V1, 2, 3 trigeminal sensory afferent limbs including Ia fibers of motor part before entering the each nuclei. A few cases of isolated trigeminal sensory change have been reported previously, we report an interesting case of pontine infarction presenting complete trigeminal afferent defects with electrophysiologic data.