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Evaluation of a Patient with the Numb Chin Syndrome

Purpose: To evaluate a patient with the numb chin syndrome.

Description

The numb chin syndrome occurs when there is injury to the inferior alveolar or mental nerves. It results in numbness with or without paresthesias over the chin and the left or right side of the mandible. It may be the presenting symptom for an occult malignancy.


Non-neoplastic causes:

(1) injection or other iatrogenic trauma

(2) noniatrogenic trauma

(3) odontogenic infections

(4) HIV infection

(5) mandibular osteomyelitis

(6) Lyme's disease

(7) syphilis

(8) mandibular atrophy in the elderly, especially with dentures

(9) vasculitis

(10) sarcoidosis

(11) amyloidosis

(12) sickle cell disease

 

Neoplastic causes:

(1) odontogenic tumors

(2) metastatic carcinoma

(3) acute leukemia

(4) malignant lymphoma

 

If non-neoplastic causes are excluded then the patient should be worked up for a neoplastic cause:

(1) panoramic radiographs of the mandible

(2) CT or MRI imaging of the head and neck

(3) lumbar puncture

(4) hematologic evaluation


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Specialty

Objective

ICD-10