Trigeminal trophic syndrome: A rare entity

Abstract

Trigeminal trophic syndrome is a rare condition resulting from self-manipulation of the skin after a peripheral or central injury to the trigeminal system. The syndrome consists of a classic triad of anaesthesia, paraesthesia, and a secondary persistent or recurrent facial ulceration. We describe a 60 year-old woman who developed this syndrome as a sequel to the gasserian ganglion block for trigeminal neuralgia. She had also developed melasma within 1 year. A remarkable benefit was achieved by proper patient education and topical antibiotics which led to the healing of all ulcerations within 4 weeks. In the case reported here, the diagnosis of the trigeminal trophic syndrome was made primarily as a result of the physician's experience with the syndrome previously.

Trigeminal trophic syndrome

“…[5] TTS presents following certain conditions and diseases like; trigeminal nerve ablation, Wallenberg syndrome (stroke/vascular insufficiency), tumor, postencephalitic sequelae, trauma, craniotomy, amyloid deposits in the CNS and trigeminal nerve, herpes zoster, herpes simplex, syphilis, and neurological complications from birth trauma or it can be idiopathic. [1] There are reports of TTS occurring in patients with leprosy and the authors of this correspondence have described the same asearly as in1991. [67] TTS is also common to occur following herpes zoster infection.…”

“…The syndrome consists of a triad of anesthesia, paresthesia, and a secondary persistent or recurrent facial ulceration. [1] It was first described as a cutaneous ulceration in the trigeminal dermatome by Wallenberg, in 1901, and later by Loveman in 1933. [23] The common dermatological causes are Hansen's disease and herpes zoster.…”

Trigeminal Trophic Syndrome Secondary to Refractory Trigeminal Neuralgia Treated with CyberKnife® Radiosurgery

“…Additionally, her skin lesions improved (Figures 3-4). with only 182 cases reported worldwide from 1933 to 2012 [1,3]. There are very few publications in the current literature, so it is in the interest of physicians to know this rare pathology.…”

“…Trigeminal trophic syndrome (TTS) is a rare pathology and classically presents with a triad of symptoms: trigeminal anesthesia, facial paresthesias, and crescent-shaped ulceration of the lateral nasal ala [1][2]. Sometimes, this syndrome occurs after significant injuries to the trigeminal nerve due to procedures and/or diseases that alter the structure of the nerve itself.…”

“…Sometimes, this syndrome occurs after significant injuries to the trigeminal nerve due to procedures and/or diseases that alter the structure of the nerve itself. As a consequence of an alteration in the sensory function of the trigeminal nerve, an exaggerated manipulation of the skin by the patient occurs, with secondary ulcers in the affected areas They are usually unilateral and located mainly at the beginning of the nose wing [1][2][3][4]. The expression of the pathology on the face is confusing and requires an exhaustive study with a differential diagnosis based on the biopsy.…”