頚椎症由来と考えられた三叉神経障害の１例

cervical spondylosis

北海道歯学会

北海道歯学雑誌

Cervical spondylosis generally causes symptoms such as numbness in the neck, shoulders and extremities, but rarely presents in the maxillofacial region. 　We experienced a case of bilateral trigeminal neuropathy thought to be caused by cervical spondylosis. We report the outline of this case with some literature considerations. 　The patient was a 68-year-old woman who visited our department with a chief complaint of numbness in the skin of the chin. Abnormal sensation at rest was observed in the skin of the area innervated by mental nerves on both sides. The patient had been aware of the chief complaint for one month without any particular trigger, and the symptoms appeared several times a day. Her medical history included surgery for left renal cancer, surgery for right breast cancer and was undergoing bisphosphonate injections for osteoporosis and hemodialysis for chronic renal failure. 　We suspected metastatic tumor of renal and breast cancer, hematopoietic malignant tumor, medication-related osteonecrosis of the jaw and brain lesions. A detailed examination was performed but the cause could not be determined. A degenerative change in the C4/5 facet joint was incidentally observed within the imaging range of MRI and an orthopedic surgeon diagnosed cervical spondylosis. The patient spent a lot of time in a forward-bent neck posture due to her hobbies such as Mahjong and Othello. Dysesthesia in the bilateral mental innervation areas disappeared as a result of conservative follow-up with posture guidance. One year and 6 mo nths after symptom improvement, no recurrence has been observed. 　Although rare, cervical spondylosis should also be considered when sensory disturbance is observed in the maxillofacial region.