Trigeminal trophic syndrome treated with thermoplastic occlusion

Kurien, Anil; Damian, Diona L.; Moloney, Fergal J.

doi:10.1111/j.1440-0960.2009.00613.x

Cited by 18 publications

(23 citation statements)

References 14 publications

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“…Patients are likely to report a preceding condition accounting for insult to the trigeminal nerve such as stroke, trigeminal neuralgia, herpes zoster, meningioma, acoustic neuroma, encephalitis, syphilis, or surgical procedures affecting the nerve . In cases where such a circumstance is not reported, magnetic resonance imaging (MRI) may also demonstrate trigeminal nerve injury or distortion and should therefore always be acquired in order to ensure underlying causes of TTS are not overlooked .…”

Section: Diagnosis Of Trigeminal Trophic Syndromementioning

confidence: 99%

“…Transcutaneous electrical nerve stimulation may lead to improvement, but relapse is common after discontinuation . Electrical stimulation, negative pressure therapy, and autologous epidermal cell transplant have been investigated with varying degrees of success . Antibiotic therapy, vitamin B treatment, hydrocolloid dressings, cervical sympathectomy, and transcutaneous electrical nerve stimulation to improve blood supply have been reported to result in healing of the wound with good outcome in single case reports .…”

Section: Management Options For Trigeminal Trophic Syndromementioning

confidence: 99%

“…Antibiotic therapy, vitamin B treatment, hydrocolloid dressings, cervical sympathectomy, and transcutaneous electrical nerve stimulation to improve blood supply have been reported to result in healing of the wound with good outcome in single case reports . Negative pressure wound therapy has been found to be effective as have thermoplastic face masks . Thermoplastic face masks may also have a role in resolving the somatization of a patient's cutaneous symptoms.…”

Section: Management Options For 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: Diagnosis Of Trigeminal Trophic Syndromementioning

confidence: 99%

Section: Management Options For Trigeminal Trophic Syndromementioning

confidence: 99%

Section: Management Options For Trigeminal Trophic Syndromementioning

confidence: 99%

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Trigeminal trophic syndrome: an updated review

2018

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“…It is important to differentiate this from somatic disorders and neurotrophic lesions, for example, in trigeminal trophic syndrome [2]. There have been isolated reports of neurotrophic ulcers in patients with Wallenberg syndrome, but its exact pathomechanism remains largely unclear [3][4][5]. The example of our patient demonstrates that ulcerations occurring in this syndrome may also be purely factitious [6].…”

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confidence: 99%

Multiple factitious hemifacial lesions in Wallenberg syndrome

Wruhs

Feldmann

Breier

et al. 2015

J Deutsche Derma Gesell

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We report on a 46-year-old man who presented with an indolent ulcer on his left nasal ala that had appeared about two weeks earlier. His relevant past medical history included a brainstem infarction with ischemia of the left cerebellar hemisphere, which had occurred three months earlier. Moreover, he was status post successful chemotherapy for Hodgkin's disease one year before. The patient had also been diagnosed with a borderline personality disorder, but was not taking any medication.Clinical examination revealed a deep, sharply demarcated crusted ulcer on his left nasal ala (Figure 1). The borders of the ulcer were not raised, and there was moderate surrounding erythema. Confined to the left side of his face, there None.

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“…Our patient was educated regarding the self-induced nature of the ulcer and was treated with a facial splint to protect the affected area from manipulation (Supplemental Figure 2). 4,5 On examination 1 month after the patient's initial evaluation, the previously involved site was almost completely healed (Figure 2 and Supplemental Figure 3). …”

mentioning

confidence: 99%