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NEUROLOGY 1992;42:1181
© 1992 American Academy of Neurology

Numb chin syndrome in cancer patients

Etiology, response to treatment, and prognostic significance

Alexander Lossos, MD and Tali Siegal, MD

Department of Neurology, Hadassah Hebrew University Hospital, Jerusalem, Israel. (Drs. Lossos and Siegal)
Department of Oncology, Hadassah Hebrew University Hospital, Jerusalem, Israel. (Dr. Siegal)

We retrospectively evaluated 42 consecutive cancer patients with numb chin syndrome (NCS). Breast cancer comprised 64% of the primary tumors, and lymphoproliferative neoplasms comprised 14%. A standard workup (including imaging of the brain, base of skull, and mandible, and CSF analysis) led to the diagnosis of a metastatic etiology in 89% of the patients. Fifty percent of the patients had mandibular metastases, 14% base-of-skull bone lesions, and 22% leptomeningeal seeding. NCS was a late manifestation of malignancy, associated with disease progression in 67% of the patients or heralding a relapse, which was often confined to the leptomeninges, in 31%. Although various therapeutic strategies led to resolution of NCS, median survival after its diagnosis was 5 months when due to bone métastases and 12 months if associated with leptomeningeal seeding.

Address correspondence and reprint requests to Dr. Tali Siegal, Neuro-Oncology Clinic, Hadassah University Hospital, P.O. Box 12000, Jerusalem 91120, Israel.

Supported in part by the Fannie Rubin Steinpress Endowment Fund and by the Nina Silverman Memorial Neurological Fund.

Presented in part at the 43rd annual meeting of the American Academy of Neurology, Boston, MA, April 1991.

Received August 21, 1991. Accepted for publication in final form November 11, 1991.




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