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A 57-year-old man presented with numbness, paraesthesia and lancinating pain on the left side of the face, which had developed suddenly 10 days previously. He had hypertension and no history of headache. His facial pain was characterised by a brief electric shock-like pain, which was evoked by light stimuli, and also occurred spontaneously. A neurological examination showed a mild decrease in sensation on the left side of the face, mainly with V2 and V3 distribution, and on the left oral cavity, including the tongue and buccal mucosa. Other neurological examinations were normal, including the corneal reflex and the motor component of the trigeminal nerve.
MRI scan of the brain revealed the presence of a subacute ischaemic lesion in the left dorsolateral pons with the ipsilateral cisternal …