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An introduction to Clinical Neurology by Alan Guberman, M.D.

Trigeminal Sensory Neuropathy and Facial Numbness

There is a unilateral form of facial numbness, with a postviral or idiopathic etiology, that usually remits over several weeks. The lower face is mainly affected and the condition is usually painless. Although the pathogenesis is unknown, this disorder may represent a sensory equivalent of Bell’s palsy. Isolated facial numbness may also occur as the result of trigeminal neuropathy secondary to herpes zoster, collagen diseases such as scleroderma, metastatic carcinoma or lymphoreticular malignancy affecting the base of the skull or meninges, diabetes, acoustic or fifth nerve neuroma, tortous vertebral arteries or lesions of the brainstem including multiple sclerosis, pontine infarction or glioma, syringobulbia, or an Arnold-Chiari malformation.

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