This is a 68 y/o man with a 4 month history of tingling of the left cheek with superimposed stabbing pain. On exam, there is diminished pin sensation over the left cheek. An initial MRI of his head was read as normal.
First, I performed a blink reflex in my office. This is an electrical test in which I stimulate the trigeminal nerve and force an individual to blink. I record how long it takes for a person to blink. In this situation, there was a clear prolongation for blinking for the left lower eyelid relative to the right lower eyelid. I then sent him for a detailed high-resolution MRI of the left eye.
This MRI scan shows a subtle lesion just under the left eyeball. A biopsy of this tumor showed lymphoma.
MRI Brain
First, I performed a blink reflex in my office. This is an electrical test in which I stimulate the trigeminal nerve and force an individual to blink. I record how long it takes for a person to blink. In this situation, there was a clear prolongation for blinking for the left lower eyelid relative to the right lower eyelid. I then sent him for a detailed high-resolution MRI of the left eye.
This MRI scan shows a subtle lesion just under the left eyeball. A biopsy of this tumor showed lymphoma.
MRI Brain
He was referred to an oncologist who treated him with systemic chemotherapy and he has been in remission for the past 6 years. All of his facial symptoms resolved completely with treatment of the underlying lymphoma.
DIAGNOSIS: Lymphoma
DIAGNOSIS: Lymphoma
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