Differential Diagnosis of Nervous System Disorders
- facial pain, numbness, weakness of masticatory muscles, trismus
- diminished / absent corneal reflex
- abnormal jaw reflex; atrophy of masticatory muscles
- decreased pain / touch / temperature sensation
- tic douloureux = paroxysmal facial pain (usually confined to V2 and V3) mainly ← neurovascular compression (tortuous elongated superior cerebellar artery / anterior inferior cerebellar artery / vertebrobasilar dolichoectasia / venous compression)
- BRAINSTEM LESION
- Vascular: infarct, AVM
- Neoplastic: glioma, metastasis
- Inflammatory: multiple sclerosis (1–8%), herpes rhombencephalitis
- Other: syringobulbia
- CISTERNAL CAUSES
- Vascular: aneurysm, AVM, vascular compression
- Neoplastic: acoustic schwannoma, meningioma, trigeminal schwannoma, epidermoid cyst, lipoma, metastasis
- Inflammatory: neuritis
- MECKEL CAVE + CAVERNOUS SINUS
- Vascular: carotid aneurysm
- Neoplastic: meningioma, trigeminal schwannoma, epidermoid cyst, lipoma, pituitary adenoma, base of skull neoplasm, metastasis, perineural tumor spread
- Inflammatory: Tolosa-Hunt syndrome
- EXTRACRANIAL
- Neoplastic: neurogenic tumor, squamous cell carcinoma, adenocarcinoma, lymphoma, adenoid cystic carcinoma, mucoepidermoid carcinoma, melanoma, metastasis, perineural tumor spread
- Inflammatory: sinusitis
- Other: masticator space abscess, trauma