Difference between revisions of "6° Clinical case: Facial onset sensory and motor neuronopathy"

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In this section of Masticationpedia 'Are we sure to know everything?​​' we present two emblematic clinical cases that demonstrate the complexity and contextually the difficulty in making a differential diagnosis between orofacial disorders and serious organic pathologies. These diagnostic difficulties and limits do not only concern the operator's clinical ability, rather the operator's forma mentis too concentrated on pre-established axioms and dogmas. In this chapter we will present a clinical case of a patient who came to our attention from the Gastroenterology department due to a state of organic food wasting that was difficult to explain in the gastrointestinal tract. The young patient (aged 40) had undergone maxillofacial surgery for a unilateral crossbite some years before she came to our attention. Once the first trigeminal electrophysiological tests were performed, our pre-diagnosis of organic neuromotor damage was concluded and the patient was immediately referred to the trigeminal neurology and neurophysiopathology departments. The definitive diagnosis was 'Facial onset sensory and motor neuronopathy' trigeminal degenerative neuropathy signed 'FOSMN'.  

Those working in centers specializing in orofacial pain or headache should be aware that a patient who initially experiences sensory disturbances on only one side may later manifest bilateral trigeminal neuropathy. Therefore, they should refer patients who begin to experience contralateral sensory symptoms for detailed diagnostic investigations. While no therapy is currently effective, early diagnosis would inform the patient of the outcome and rule out other possibly treatable causes.

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== Introduction ==