Case & reviewThe trigeminal trophic syndrome: an unusual cause of nasal ulceration☆
Section snippets
Case report
A 52-year-old woman presented with progressive ulceration of the right ala nasi. Twenty-one years previously she had cryptogenic, ipsilateral Bell's palsy, complicated by severe trigeminal neuralgia. This was managed successfully with oral carbamazepine, however, adverse effects of the drug required its discontinuation in 1997, leaving the patient with intractable pain. For this reason, the patient underwent radiofrequency trigeminal rhizotomy 4 years before presentation. Postoperatively, she
Discussion
TTS is an unusual condition after damage to the sensory root of the trigeminal nerve, with subsequent progressive ulceration in the affected dermatome. Initially described by Wallenberg,1, 2 TTS first appeared in the English-language literature 32 years later in independent publications by Loveman3 and McKenzie.4 More than 100 cases have subsequently been described.2, 5
The most common presentation of TTS follows trigeminal ablation by rhizotomy or alcohol injection into the gasserian ganglion.2
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Supported by National Institutes of Health grant HL007749.
Conflicts of interest: None identified.