Neuropathy of the trigeminal nerve may present as facial numbness. Its presence in the absence of trauma or surgery may be indicate a serious underlying disease.
Patient selection: facial numbness not due to trauma or surgery
Differential diagnosis includes:
(1) perineural spread of a malignant tumor (squamous cell carcinoma, nasopharyngeal carcinoma, metastatic adenocarcinoma, other)
(2) invasive fungal infection (orbital apex, cavernous sinus)
(3) bacterial abscess or cellulitis
(4) benign tumor (schwannoma, meningioma)
(5) neuropathy
Sites where involvement of the trigeminal nerve may occur include:
(1) cerebellopontine angle
(2) Meckel's cave (Gasserian ganglion)
(3) cavernous sinus
