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Updated: Aug 11, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Multiple sclerosis as first manifestation in oral and facial area: presentation of four cases
Lola Gallud1, José V Bagan, Angeles Cervelló
1Stomatology Department, Hospital General Universitario. gallud_lola@ono.com
Abstract:
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system, whose etiology is unknown, and which is characteristic by the appearance of a diverse neurological symptomatology consisting of outbreaks or gradual deterioration and lesions in any location of the brain s white matter which may provoke the after-effect of a definitive demyelination of the area. The disease affects young people, with its appearance being most frequent between 20 and 40 years of age, in temperate and cold climates, and with a man-woman rate of 0.46/0.67. The magnitude of this disease lies in the fact that it is the primary cause for permanent disablement among young adults. We are presenting 4 cases of MS whose initial symptom of the disease was the appearance of paraesthesia in the maxillofacial area, affecting one or more ramifications of the trigeminal nerve, and a progression time varying from 15 days to one year. All the patients were clinically diagnosed, with their diagnostics being confirmed both with magnetic resonance imaging as well as through the study of their cerebrospinal fluid (CSF) and the evoked potentials (EPs). Manifestations in the oral and facial area were the first manifestation of the disease in all cases.
Insights
Multiple sclerosis (MS) can initially present as facial numbness. This study highlights four cases where trigeminal nerve paresthesia preceded other typical MS symptoms, emphasizing the need for broader diagnostic considerations.
Area of Science:
- Neurology
- Immunology
Background:
- Multiple sclerosis (MS) is a chronic central nervous system inflammatory disease with unknown etiology.
- It is a leading cause of permanent disability in young adults, typically affecting individuals aged 20-40.
- MS is characterized by neurological symptoms, central nervous system lesions, and demyelination.
Purpose of the Study:
- To report on four cases of MS where the initial symptom was maxillofacial paresthesia.
- To investigate the diagnostic pathway and confirmation methods for these cases.
Main Methods:
- Clinical diagnosis of Multiple Sclerosis (MS).
- Confirmation through Magnetic Resonance Imaging (MRI).
- Cerebrospinal fluid (CSF) analysis and Evoked Potentials (EPs) studies.
Main Results:
- Four cases of MS presented initially with paresthesia in the maxillofacial area, involving trigeminal nerve branches.
- Symptom progression varied from 15 days to one year.
- Facial and oral area manifestations were the first presenting symptoms in all reported cases.
Conclusions:
- Maxillofacial paresthesia can be an early, presenting symptom of Multiple Sclerosis (MS).
- Early recognition of such atypical presentations is crucial for timely diagnosis and management of MS.
- Diagnostic confirmation relies on a combination of clinical evaluation, MRI, CSF analysis, and EPs.
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