Clinical features

Clinical features of trigeminal nerve palsy are related to loss of sensation in the areas supplied by the nerve and/ or loss of motor function for the muscles of mastication.

They include:

• absent corneal reflex, with the patient unable to feel the cotton wool - this relates to the ophthalmic division of the trigeminal nerve
• loss of facial sensation - if there is total loss of sensation in all three divisions then this is suggestive of a lesion at the ganglion or sensory root, e.g. an acoustic neuroma
• inability to hold the mouth open - pterygoids - against light force from an examiner
• denervation atrophy of the muscles of mastication
• unilateral lesions of the motor division may result in deviation of the jaw to the weakened - affected - side

Reference

1. Miscov R, Gulisano HA, Bjarkam CR. Recognition, classification and treatment of trigeminal neuropathy. Ugeskr Laeger. 2022 Jan 10;184(2)