Trigeminal Sensory Neuropathy in Systemic Lupus Erythematosus

Five women are presented who had the unusual picture of trigeminal neuropathy affecting the sensory function. In 4 of the cases the symptoms were bilateral and fairly symmetrical, but not corresponding to the trigeminal branches. In 4 of the cases the trigeminal neuropathy was the only neurological finding. Three of the patients suffered from systematic lupus erythematosus (SLE), in the 2 others this diagnosis was strongly suspected. It is suggested that the neuropathy was caused by vascular lesions in the medulla oblongata. The bilateral engagement may depend upon the anatomic arrangement of the arterial supply to the trigeminal decussation and lemniseus. The distribution of the sensory loss can be explained by the somatotopic localisation in the nerve tracts. Reports on cases with isolated sensory trigeminal neuropathy have been published in the last two decades. It is suggested that the neuropathy, at least in some of these cases, may have been an early symptom of SLE.