The difference in clinical characteristics in the patients with unilateral oral cenesthopathy with and without the neurovascular compression of trigeminal nerve: A clinical chart review

Abstract Background Oral cenesthopathy (OC) is characterized by unusual sensation in the oral cavity without corresponding medical and dental evidence. Their complaints are vary and some patients show sever symptoms which decline their quality of life. The neurovascular compression (NVC) of trigeminal nerves is known as one of the factors to indicate abnormal sensation in facial area including oral cavity. The aim of the present study was to investigate the pathophysiology of OC by comparing the clinical characteristics of unilateral OC patients with and without trigeminal nerve NVC. Methods This is a retrospective study reviewing medical records of patients diagnosed with unilateral OC seen between April 2016 and February 2019. Magnetic resonance images (MRI) were performed to assess the presence of NVC. Results Among 321 patients who were diagnosed with OC, 87 patients showed unilateral OC. finally, 52 patients who were performed MRI were involved in the present investigation. In 48.1% subjects (25/52), NVC of trigeminal nerves was observed. In the patients without NVC, 85.2% (23/27) were female with significant difference (p = 0.010) compared to the patients with NVC (48.0%, 12/25). There was no significant difference in age, the presence of psychiatric history and psychosomatic dental comorbidity, and the scores of psychological questionnaires. However, in the patients without NVC, significantly higher scores were observed in the symptom severity and the functional impairment as follow; movement (p = 0.042), pain (p = 0.040), work (p = 0.013) and social activities (p = 0.015), compared to the group with NVC. Conclusion These results suggest that unilateral OC has two subtypes based on predominant involvement of peripheral or central nervous system (CNS). The unilateral OC with NVC may involve predominantly peripheral nervous system. Furthermore, the unilateral OC without trigeminal nerve NVC which showed severe functional impairment may be reflected predominant CNS involvement.