Pontine Infarct Presenting with Atypical Dental Pain: A Case Report

Rajat Goel 1, Sanjeev Kumar 2, Ajay Panwar 3, *, Abhishek B Singh 4
1 Department of Endodontics, SGT Dental College Hospital and Research Institute, Gurgaon, India
2 Department of Medicine, Lala Lajpat Rai Memorial Medical College, Meerut, India
3 Department of Neurology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
4 Department of ENT, Uttar Pradesh Regional Institute of Medical Sciences and Research, Saifai, India

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© Goel et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Neurology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India; Tel: +917499171227; E-mail:


Orofacial pain’ most commonly occurs due to dental causes like caries, gingivitis or periodontitis. Other common causes of ‘orofacial pain’ are sinusitis, temporomandibular joint(TMJ) dysfunction, otitis externa, tension headache and migraine. In some patients, the etiology of ‘orofacial pain’ remains undetected despite optimal evaluation. A few patients in the practice of clinical dentistry presents with dental pain without any identifiable dental etiology. Such patients are classified under the category of ‘atypical odontalgia’. ‘Atypical odontalgia’ is reported to be prevalent in 2.1% of the individuals. ‘Atypical orofacial pain’ and ‘atypical odontalgia’ can result from the neurological diseases like multiple sclerosis, trigeminal neuralgia and herpes infection. Trigeminal neuralgia has been frequently documented as a cause of ‘atypical orofacial pain’ and ‘atypical odontalgia’. There are a few isolated case reports of acute pontine stroke resulting in ‘atypical orofacial pain’ and ‘atypical odontalgia’. However, pontine stroke as a cause of atypical odontalgia is limited to only a few cases, hence prevalence is not established. This case is one, where a patient presented with acute onset atypical dental pain with no identifiable dental etiology, further diagnosed as an acute pontine infarct on neuroimaging. A 40 years old male presented with acute onset, diffuse teeth pain on right side. Dental examination was normal. Magnetic resonance imaging(MRI) of the brain had an acute infarct in right pons near the trigeminal root entry zone(REZ). Pontine infarct presenting with dental pain as a manifestation of trigeminal neuropathy, has rarely been reported previously. This stresses on the importance of neuroradiology in evaluation of atypical cases of dental pain.

Keywords: Pontine stroke, Trigeminal neuropathy, trigeminal neuralgia.