Numb Chin Syndrome with Four Fulminant Attacks in 16 Years

Abstract

We present a case report of an otherwise healthy 68-year-old man with a 16-year follow-up of recurrent sudden and severe attacks of painful but benign numb chin syndrome (NCS).The patient presented with only one subjective finding: recurrent mental nerve neuropathy, a periodic, localized, atypical facial pain continuing up to 2 weeks at a time. Undergoing tests on an outpatient basis, a complete lab work-up including dental examination and laboratory tests, electroencephalogram, chest x-ray, abdominal ultrasonography, head and neck magnetic resonance imaging and computed tomography were done.All examinations and test results were within normal limits and with no remarkable findings in 16 years of follow-up. After family, social, surgical, medical, dental, and psychological histories, with appropriate and careful clinical work-ups, no definitive diagnoses, other than NCS, could be made. An extensive literature search in the PubMed interface using the key words, "numb chin syndrome," "mental neuropathy," and "mental nerve numbness," revealed 152 articles reporting 576 patients. As reported, NCS can be benign or a precursor of certain cancers, leukemia, other morbidity, and mortality. Though inconveniencing and embarrassing, painful and extremely worrying during the periods of infliction, the present case of NCS has been benign for 16 years.