Isolated trigeminal sensory neuropathy due to pontine hemorrhage has only been found in a few previous cases [1-4]. In these, the hemorrhage affected either the principal sensory nucleus [1, 2] or the trigeminal nerve roots [3, 4] and produced facial sensory impairments along the ophthalmic (V1), maxillary (V2) and/or mandibular(V3) nerve dermatome. We report a patient with a small pontine hemorrhage that affected the upper part of the spinal trigeminal nuclei, mainly the nucleus oralisand interpolaris. She developed isolated facial tactile sensory impairment with 'onion skin' distribution in the absence of other neurological deficits. Onion skin type facial sensory impairment caused by these upper spinal trigeminal nuclei due to stroke has never been previously reported.
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