A case report: Numb Chin Syndrome due to thalamic infarction: a rare case

• Published in: BMC neurology Vol. 19; no. 1; p. 303
• Main Authors: Rimmele, Florian, Maschke, Henning, Großmann, Annette, Jürgens, Tim P
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 29.11.2019; BioMed Central; BMC
• Subjects: Breast cancer; Case Report; Case reports; Cerebral infarction; Cerebral Infarction - complications; Cheiro-Oral syndrome; Chin - innervation; Diagnosis; Family medical history; Humans; Hypertension; Hypesthesia - etiology; Ischemia; Jaw; Lip; Lyme disease; Magnetic resonance imaging; Male; Medical prognosis; Metastasis; Middle Aged; Multiple sclerosis; Nervous system diseases; Neurologic examination; Neurological diseases; Neuropathy; Numb Chin syndrome; Numbness; Patients; Prostate cancer; Sensory neuropathy; Syndrome; Thalamic stroke; Thalamus; Trigeminal; Tumors; Veins & arteries; Sensory neuropathy; Thalamic stroke; Cheiro-Oral syndrome; Numb Chin syndrome; Trigeminal
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/s12883-019-1525-x

Numb Chin Syndrome (NCS), which is also characterized as sensory neuropathy of the mental nerve, describes a mostly unilateral numbness of the chin and lower lip. Benign and malignant diseases are known to cause this circumscribed symptom, which can easily be overlooked or misdiagnosed. In this article we present the very rare case of a clinical NCS caused by thalamic lacunar infarction. As a pure sensory stroke it is a rare variant of the Cheiro-Oral Syndrome (COS). A 63-year-old male patient received an emergency referral to our department after the patient had noticed a feeling of numbness of the left lower lip and chin on the previous day. The neurological examination revealed an approximately 2 × 3 cm area of hypoesthesia in the area of the chin and left lower lip and the cranial MRI an acute ischemia in the right thalamus. In this case report we introduce a patient who clinically shows an NCS. Various diseases may be responsible for NCS, including malignancies or even central neurological disorders such as multiple sclerosis. A lacunar thalamic ischemia as a cause of NCS is very rare and to our knowledge described in the literature only in the contex of a COS in three cases. We wish to remind the reader, through this case, of the purely descriptive and syndromal character of the NCS and the importance for detecting underlying diseases. Furthermore we give a brief overview of the NCS and causative disorders.