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Mult Scler Relat Disord. 2016 Sep;9:140-6. doi: 10.1016/j.msard.2016.07.009. Epub 2016 Jul 12.

A neurophysiological study of facial numbness in multiple sclerosis: Integration with clinical data and imaging findings.

Author information

1
1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: gkoutsi2@otenet.gr.
2
1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Abstract

OBJECTIVE:

To integrate neurophysiological findings with clinical and imaging data in a consecutive series of multiple sclerosis (MS) patients developing facial numbness during the course of an MS attack.

METHODS:

Nine consecutive patients with MS and recent-onset facial numbness were studied clinically, imaged with routine MRI, and assessed neurophysiologically with trigeminal somatosensory evoked potential (TSEP), blink reflex (BR), masseter reflex (MR), facial nerve conduction, facial muscle and masseter EMG studies.

RESULTS:

All patients had unilateral facial hypoesthesia on examination and lesions in the ipsilateral pontine tegmentum on MRI. All patients had abnormal TSEPs upon stimulation of the affected side, excepting one that was tested following remission of numbness. BR was the second most sensitive neurophysiological method with 6/9 examinations exhibiting an abnormal R1 component. The MR was abnormal in 3/6 patients, always on the affected side. Facial conduction and EMG studies were normal in all patients but one.

CONCLUSIONS:

Facial numbness was always related to abnormal TSEPs. A concomitant R1 abnormality on BR allowed localization of the responsible pontine lesion, which closely corresponded with MRI findings. We conclude that neurophysiological assessment of MS patients with facial numbness is a sensitive tool, which complements MRI, and can improve lesion localization.

KEYWORDS:

Blink reflex; Facial numbness; MS; Multiple sclerosis; Trigeminal nerve; Trigeminal somatosensory evoked potentials

PMID:
27645362
DOI:
10.1016/j.msard.2016.07.009
[Indexed for MEDLINE]

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