Trigeminal trophic syndrome

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Trigeminal trophic syndrome
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Facial pain, ulceration of the nasal ala
Complications	Infection, scarring
Onset	Typically after trigeminal nerve injury
Duration	Chronic
Types	N/A
Causes	Damage to the trigeminal nerve
Risks	Surgery, trauma, herpes zoster
Diagnosis	Clinical evaluation, biopsy
Differential diagnosis	Lupus vulgaris, basal cell carcinoma, granulomatosis with polyangiitis
Prevention	N/A
Treatment	Topical antibiotics, gabapentin, amitriptyline
Medication	N/A
Prognosis	Variable, often chronic
Frequency	Rare
Deaths	N/A

Trigeminal trophic syndrome (TTS) is a rare neurological disorder characterized by the triad of facial anesthesia, paresthesia, and the development of ulcerative lesions, typically on the nasal ala. This condition results from damage to the trigeminal nerve, which is responsible for sensation in the face and motor functions such as biting and chewing.

Etiology

The primary cause of TTS is damage to the trigeminal nerve, often due to surgical procedures, trauma, or diseases such as herpes zoster. The damage leads to a loss of sensation in the affected area, which can result in self-inflicted injuries as patients may not feel pain and continue to scratch or rub the area, leading to ulceration.

Clinical Features

Patients with TTS typically present with:

• Facial anesthesia: Loss of sensation in the affected area.
• Paresthesia: Abnormal sensations such as tingling or burning.
• Ulcerative lesions: Chronic, non-healing ulcers, most commonly on the nasal ala.

Diagnosis

Diagnosis of TTS is primarily clinical, based on the characteristic triad of symptoms. A detailed patient history and physical examination are crucial. Imaging studies such as MRI or CT scan may be used to identify the underlying cause of trigeminal nerve damage.

Treatment

Treatment of TTS focuses on managing symptoms and preventing further self-inflicted injury. Approaches include:

• Protective measures: Using barriers or dressings to protect the affected area.
• Medications: Topical or systemic medications to reduce paresthesia and promote healing.
• Behavioral therapy: Techniques to prevent self-inflicted injuries.

Prognosis

The prognosis for TTS varies depending on the underlying cause and the effectiveness of treatment strategies. While the condition can be challenging to manage, early intervention and comprehensive care can improve outcomes.

See also

• Trigeminal nerve
• Herpes zoster
• Neurological disorder
• Paresthesia
• Facial anesthesia

External links

• DermNet

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