A rare case of bilateral trigeminal palsy presenting as a complication of Sjogren syndrome

Sjogren syndrome is a chronic disorder affecting the exocrine glands of the body, mostly lacrimal and salivary glands, resulting in sicca symptoms. Diagnosis is aided by the presence of anti-Ro and anti-La antibodies and gland biopsy showing lymphocytic infiltration. Bilateral loss of facial sensation in Sjogren syndrome (SS) has not been reported before, although unilateral trigeminal palsy as a presentation of SS has been reported in literature. A 25-year-old lady presented in the neurology clinic with complete facial numbness and vision loss for 1 month. The vision worsened, leading to complete blindness. She had dry mouth and dry eyes for the past 3 months. She was diagnosed with SS using American–European consensus Sjogren criteria. Electrophysiological blink reflex testing confirmed complete trigeminal nerve palsy. SS was treated with prednisolone, 1 mg/kg/ day, with a poor response. Symptomatic treatment was given for sicca symptoms, which improved significantly. Corneal transplantation was done for visual loss, but limited improvement was seen.