Síndrome trófica trigeminal: relato de caso

Abstract

The trigeminal trophic syndrome (STT) is a rare cause of chronic ulcers in the face that occur in the areas of innervation of the trigeminal nerve, especially the wing of the nose. Its clinical approach involves two challenging reasons, one in the difficulty of diagnosis by the number of differential diagnoses, another in the therapeutics due to the resolution problem because they are self-induced ulcerations of difficult control. The present work describes a patient with a complication resulting from STT after unilateral trigeminal rizotomy, which is classically characterized by the triad of anesthesia, paresthesia and chronic ulcerations involving the skin of the face and the nasal mucosa. After frustrating and mutilating diagnostic attempts to eliminate the possibility of malignancy and infection, it was possible, based on medical history, to apply a form of noninvasive therapy based on local care and laser application where it showed significant improvement and control of ulceration. Faced with a history that associates trigeminal nerve rhizotomy or ablation with simultaneous occurrence of peripheral ulcers that are resistant to healing in the nose wing, any more invasive diagnostic procedure should occur after the possibility of STT is discarded.