Trigeminal trophic syndrome

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.

show abstract

“…A slight female predilection of 2.2:1 has been documented . Approximately 5% of cases are idiopathic …”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Trigeminal trophic syndrome: an updated review

2018

View full text Add to dashboard Cite

show abstract

“…19 Although psychiatric factors are important in factitious dermatitis, they are not considered important in TTS. 27 The differential diagnosis of TTS from factitial skin disorders should be addressed. Patients with factitial skin syndromes differ from those with TTS in that such patients have normal skin sensitivity, must undergo compulsive behavior modification, and have a bilateral and often symmetrical distribution of skin lesions.…”

Section: Discussionmentioning

confidence: 99%

Trigeminal trophic syndrome of all three nerve branches: an underrecognized complication after brain surgery

Lukšić

Šestan-Crnek

et al. 2008

JNS

View full text Add to dashboard Cite

The authors report a case of trigeminal trophic syndrome (TTS) that occurred as a complication of a neurosurgical procedure. Three years after a second surgical treatment for a meningioma of the cerebellopontine angle, this 32-year-old woman developed TTS with progressive skin ulcers on the left ala nasi and the left side of the forehead and chin. Trigeminal trophic syndrome is an extremely rare cause of facial ulceration. It occurs as a consequence of trigeminal nerve damage or impaired central sensory connections. To the authors' knowledge, this is the first report of lesions in the dermatomes of all three branches of the nerve after a neurosurgical procedure. Early recognition of this disorder is important, as treatment is difficult and often unsatisfactory. Many clinicians are not aware of this disease, thus, it may be more common than previously thought. The importance of recognizing and diagnosing TTS, as well as its treatment, are discussed.

show abstract

“…1,2,4,5 Treatment should be centered on behavioral modification intended to reduce self-induced trauma. 7,8 Occlusive dressings can also prevent handling and perpetuation of the skin lesions by the patients. Pharmacotherapy with carbamazepine, amitriptyline, diazepam, chlorpromazine, and pimozide has been used with varying results.…”

Section: Differential Diagnosis Of Tts Includes Various Diseasesmentioning

confidence: 99%

“…Pharmacotherapy with carbamazepine, amitriptyline, diazepam, chlorpromazine, and pimozide has been used with varying results. 8 Other reported modalities of management include hydrocolloid dressings, transcutaneous electrical nerve stimulation, plastic surgery with innervated flaps, and negative pressure wound therapy. 2,4,5 The present case was successfully managed with counseling, occlusive dressings, and carbamazepine.…”

Section: Differential Diagnosis Of Tts Includes Various Diseasesmentioning

confidence: 99%

Trigeminal trophic syndrome

2017

Journal of the American Academy of Dermatology

View full text Add to dashboard Cite

in adults. 6 The metabolism of both drugs is still unknown. Later, researchers realized that the condition is caused by self manipulation of the desensate itchy skin in a reflexive action to get rid of the troublesome dysethesias. 3,6 Although TTS characteristically affects the ipsilateral nasal ala, cheeks, and upper lip, involving the V2 or V3 dermatomes, it can appear anywhere in the trigeminal innervation territory. 6 TTS following herpes zoster involving the scalp and forehead is a less common presentation.

show abstract

Trigeminal trophic syndrome

Cited by 9 publications

References 8 publications

Trigeminal trophic syndrome: an updated review

Trigeminal trophic syndrome: an updated review

Trigeminal trophic syndrome of all three nerve branches: an underrecognized complication after brain surgery

Trigeminal trophic syndrome

Contact Info

Product

Resources

About