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Case 3. Numb face

Clinical formulation

Acute, evolving, right hemifacial and internal oral cavity sensory disturbance. The likely lesion is somewhere between the ganglion, nerve or pons. The evolving tempo suggests an inflammatory cause rather than vascular and seems too fast for neoplasia.

Demyelination in the pons is possible, alternatively an acute trigeminal ganglionopathy/neuropathy.

Outcome