Pain in the numb chin syndrome.

摘要

The case report and expert opinion commentary by Drs. Evans, Kirby, and Purdy on the numb chin syndrome thoroughly reviewed this uncommon sensory neuropathy and appropriately emphasized its ominous implications for the presence of an underlying or a recurrent malignancy.Although treatment is often appropriately focused on managing the underlying etiology, symptomatic therapy may be important, as pain in this syndrome can be severe. The authors seem to be reporting the first case of painful numb chin syndrome treated symptomatically with an agent targeting neuropathic pain. I saw a 15-year-old boy who presented with an acute right painful mental-nerve neuropathy in the context of a sickle cell crisis. Imaging of his maxillofacial structures was unremarkable, and the etiology was ascribed to mental-nerve infarction. His facial pain did not respond to narcotics and aggressive intravenous fluid resuscitation. Similar to the case described by Evans et al, oral pregabalin was used to treat the patient symptomatically, mainly because of its efficacy in treating acute neuropathic pain in zoster, where benefit may be seen within 24 h. After 3 days of treatment with pregabalin 75 mg 3 times daily, his facial pain completely ceased, although the chin hypoesthesia remained. Pregabalin was tapered off after 5 days of treatment and the facial pain did not recur in the subsequent 2 weeks.