Cicatricial Eyelid Paralysis Secondary to Trigeminal Trophic Syndrome

Kovacs, Kyle D.; Ehrlich, Michael

doi:10.1097/iop.0000000000000766

Cited by 2 publications

(5 citation statements)

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“…Soft tissue scarring can draw the upper lip into a characteristic sneer . Eye lesions are more common than expected; TTS can often result in eyelid involvement, typically manifesting as ulceration with corneal exposure that responds poorly to surgical intervention given poor tissue healing …”

Section: Clinical Featuresmentioning

confidence: 99%

“…Instead, they have been reported to show ulceration with adjacent lichenification and epidermal and dermal scarring with mild mixed inflammatory cell infiltrate . Reports of acanthosis, hypergranulosis, and hyperkeratosis are common …”

Section: Histology Of Trigeminal Trophic Syndromementioning

confidence: 99%

“…5,18 Eye lesions are more common than expected; 3 TTS can often result in eyelid involvement, typically manifesting as ulceration with corneal exposure that responds poorly to surgical intervention given poor tissue healing. 19 The time of onset after neurological insult is variable from months to decades.…”

Section: Pathogenesis Of Trigeminal Trophic Syndromementioning

confidence: 99%

“…15,25 Reports of acanthosis, hypergranulosis, and hyperkeratosis are common. 19 The pathology of affected skin in patients with postherpetic neuralgia often reveals distal nociceptive axon loss. 1,28 Chronic neuropathic pain leads to a reduction in density of cutaneous nociceptive innervation.…”

Section: Histology Of Trigeminal Trophic Syndromementioning

confidence: 99%

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Trigeminal trophic syndrome: an updated review

2018

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Trigeminal trophic syndrome (TTS) is a rare disease process that is thought to occur after insult to the trigeminal nerve. The earliest descriptions of this condition were provided in the early 20th century, yet it remains relatively unknown, with approximately 200 cases since described. Most commonly seen in older women, TTS characteristically involves persistent facial ulceration with loss of sensation and paresthesia along the distribution of the trigeminal dermatome. Ulceration often occurs in the alar region, following self-manipulation in response to paresthesias. Time of onset of TTS after trigeminal insult may vary from weeks to decades, and emergence of ulceration may be associated with psychiatric disorders. Diagnosis is clinical and made by exclusion of similarly presenting conditions. Histology is nonspecific yet necessary to exclude other causes of facial ulceration. Although there is not yet a standard management strategy, a number of successful approaches have been reported including pharmaceutical and surgical interventions, installation of a protector, and transcutaneous nerve stimulation. However, because of the self-inflicted manifestations of this disorder, behavioral modifications remain of the utmost importance. This review serves to address the history, epidemiology, pathogenesis, clinical presentation, histology, diagnosis, differential diagnosis, and management options for TTS.

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Section: Clinical Featuresmentioning

confidence: 99%

Section: Histology Of Trigeminal Trophic Syndromementioning

confidence: 99%

Section: Pathogenesis Of Trigeminal Trophic Syndromementioning

confidence: 99%

Section: Histology Of Trigeminal Trophic Syndromementioning

confidence: 99%

See 2 more Smart Citations

Trigeminal trophic syndrome: an updated review

2018

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“…It typically manifests as an ulceration with corneal exposure. 10 Treatment of TTS requires a multidisciplinary approach (dermatology, neurology, psychiatry, ophthalmology, surgery). There is no proven standard treatment protocol.…”

Section: Discussionmentioning

confidence: 99%

Trigeminal trophic syndrome associated with neuralgia after ischemic stroke—a case report

Rybak‐d′Obyrn,

Alicja,

Joanna

et al. 2023

Clinical Case Reports

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Trigeminal trophic syndrome (TTS) is a rare condition resulting from self‐manipulation of the skin after an injury to the trigeminal nerve. We describe the case of a 70‐year‐old woman who was hospitalized because of erythema, ulceration, and crusts on the right side of her face, accompanied by itching, burning, and irritation forcing self‐manipulation of the skin. She had been previously repeatedly treated with antibiotics, acyclovir, and topical medications without any improvement. Her medical history revealed an episode of ischemic stroke in 2016, after which a deformation and partial atrophy of the right ala nasi appeared. Trigeminal neuropathy was confirmed by a neurological consultation. Diagnosis and treatment of TTS requires a multidisciplinary approach. Awareness of this disease should be raised to enable proper diagnosis and management of difficult‐to‐treat facial ulcers that cannot be explained by common causes.

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Cicatricial Eyelid Paralysis Secondary to Trigeminal Trophic Syndrome

Cited by 2 publications

References 0 publications

Trigeminal trophic syndrome: an updated review

Trigeminal trophic syndrome: an updated review

Trigeminal trophic syndrome associated with neuralgia after ischemic stroke—a case report

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