Isolated Facial Numbness

Sixty-four patients had an initial or presenting symptom of facial numbness that had been present from 3 days to 7 years before initial examination. Excluding 4 patients lost to follow-up, 53 patients had trigeminal involvement secondary to other conditions (27 with tumors of the cerebellopontine angle and the base of the skull; 2 with intramedullary tumors; 5 with multiple sclerosis; 6 with ipsilateral facial or abducens nerve palsies in addition to numbness, presumably on a viral basis; 3 with dental and facial trauma; 2 with vertebrobasilar vascular disease; and 8 with miscellaneous disorders). In seven patients (11.7%) no underlying disease was found, and the diagnosis of primary trigeminal disease, previously called trigeminal (sensory) neuropathy, was made. Isolated facial numbness is a symptom of serious portent, requiring thorough neurological evaluation in every case.