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Difference between revisions of "6° Clinical case: Facial onset sensory and motor neuronopathy"
6° Clinical case: Facial onset sensory and motor neuronopathy (view source)
Revision as of 17:12, 19 October 2024
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'''Abstract:''' This section of Masticationpedia introduces two clinical cases to illustrate the complexities and challenges of differential diagnosis between Orofacial Disorders and more serious organic pathologies. The difficulty in diagnosis often extends beyond clinical skills, stemming from cognitive biases tied to dogmatic approaches and pre-established protocols such as the RDC/TMD, P-values, false positives/negatives, and specialized contexts. The section emphasizes the need for clinicians to critically reflect on these limitations and warns against over-reliance on automated diagnostic models without maintaining a nuanced understanding of patient-specific details. | |||
A clinical case involving a 40-year-old female patient, pseudonymously named ‘Flora,’ who suffered from weight loss, facial tingling, and gum recession after maxillofacial surgery, highlights the complexity of such diagnostic processes. Despite several misdiagnoses, electrophysiological tests, including the jaw jerk and mechanical silent period, led to the discovery of severe trigeminal nerve damage, contradicting the previous diagnosis of a dental issue. The case underscores the significance of context in diagnosis, showing how symptoms might overlap with conditions like Temporomandibular Disorders (TMDs) or Facial Onset Sensory and Motor Neuronopathy (FOSMN), and how cognitive neural network (CNN) models can aid in systematically navigating complex clinical data. | |||
Through a step-by-step investigation, the clinical team bypassed conventional protocols and applied an advanced cognitive diagnostic model to detect FOSMN. Neurological assessments, including trigeminal motor evoked potentials and reflex studies, confirmed the diagnosis. The analysis of the patient’s symptoms and test results, compared with literature, revealed the progression of neuropathy from larger to smaller myelinated fibers, highlighting the critical role of advanced neurophysiological diagnostics in early detection. | |||
The abstract concludes by posing a critical question regarding the pathogenesis of the disorder in the patient’s trigeminal V3 area, suggesting that iatrogenic causes may not fully explain the progression of the disease. The case challenges clinicians to consider multifaceted diagnostic approaches and to remain open to evolving scientific paradigms when dealing with complex neurological and orofacial conditions. | |||
==Introduction== | ==Introduction== | ||