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126:Persistent orofacial pain associated with nasopharyngeal extramedullary plasmacytoma[AAOM2020}
EP35995
Poster Title: 126:Persistent orofacial pain associated with nasopharyngeal extramedullary plasmacytoma[AAOM2020}
Submitted on 29 Mar 2021
Author(s): Roopali Kulkarni, DMD, MPH., Rawan Ashshi, BDS*., Thomas P. Sollecito, DMD., Takako I. Tanaka, DDS, Eric T. Stoopler, DMD.,
Affiliations: Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
This poster was presented at 2021 American Academy of Oral Medicine Virtual Conference
Poster Views: 63
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Poster Information
Abstract: Background: Painful post-traumatic trigeminal neuropathy (PTTN) is a neuropathic pain disorder of traumatic origin affecting central or peripheral branches of the trigeminal nerve. The condition is more prevalent in females with onset typically between 45-50 years of age. PTTN symptoms vary considerably and include allodynia, hyperalgesia, dysesthesia and other sensory disturbances. PTTN is associated with facial trauma and iatrogenic injuries associated with dental treatment, including local anesthetic injections, endodontic procedures and oral surgical procedures, such as dental extractions.

Case report: A 44-year-old male complained of continuous burning of the right palate and tongue of 7 months’ duration. Onset of symptoms were associated with consuming a hot fish sandwich with subsequentthermal injuries to the affected areas. Burning sensations persisted after thermal injuries healed without modifying factors. Patient reported transientrelief of symptoms with topical anesthetic rinse. Past medical, surgical, family and social histories were unremarkable. No medications and no known drug / food allergies were reported. Review of systems was unremarkable. Extraoral examination revealed a well-nourished, well-developed male in no apparent distress without evidence of lymphadenopathy, salivary gland enlargement or thyromegaly. Cranial nerves II – XII were grossly intact. Intraoral examination was without mass, lesion(s) or ulcer(s) to the oral mucosa. Diagnosis was consistent with PTTNand glossodynia localized to the right hard palate and dorsal tongue, respectively. Alpha lipoic acid 200 mg three times a day was initiated without benefit. Subsequently, gabapentin solution 250 mg/5ml swish and spit twice daily was prescribed without benefit. The patient is currently taking gabapentin 300mg daily and pending clinical re-evaluation.

Conclusions:PTTN may present as a diagnostic and therapeutic challenge. This case is unique due to the association of PTTN with thermal injuries of the oral mucosa and patient gender. Oral health care providers should be knowledgeable about PTTN to provide optimal health care.
Summary: Painful post-traumatic trigeminal neuropathy (PTTN) is a neuropathic pain disorder of traumatic origin affecting central or peripheral branches of the trigeminal nerve. The condition is more prevalent in females with onset typically between 45-50 years of age. PTTN symptoms vary considerably and include allodynia, hyperalgesia, dysesthesia and other sensory disturbances.

Ask the author questions about this poster:Rawan3shi@hotmail.com
References: 1. Straetmans J, Stokroos R. Extramedullary plasmacytomas in the head and neck region. Eur Arch Otorhinolaryngol
2008;265:1417-32.
2. Pham A, Mahindra A. Solitary plasmacytoma: A review of diagnosis and management. Current Hematologic
Malignancy Reports. 2019;14:63-9.
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