Quiz Form

Question Date: 27/09/2023

Question: A 76 year old lady presented with numbness on right side of chin. There was no history of recent dental procedure. Examination showed numbness over the chin on the right side, rest of the cranial nerves being normal <br><br>Which statement is true regarding this condition?

Options:

• This may represent trigeminal neuropathy
• MRI of the brain is sufficient for evaluation
• Corneal reflex is absent on the affected side
• Metastatic malignancy should be suspected

Correct Answer: Metastatic malignancy should be suspected

Explaination: The numb chin syndrome presents with numbness on one side of the chin and lip. In the absence of a dental procedure, it suggests neuropathy of the inferior alveolar or mental nerve. It results from direct invasion of the nerve or mandible from a malignant process such as squamous cell carcinoma or distant metastases. It was most commonly associated with breast cancer followed by lymphoma, prostate cancer and leukemia. Rarely, it may be due to leptomeningeal metastases. An MRI of the brain may not suffice and additional study of the mandible with contrast should also be included. The corneal reflex is expected to be spared in an inferior alveolar neuropathy.

Reference: Robertson C. Cranial Neuralgias. Continuum 2021 27(3 Headache)665-685