Trigeminal ganglionopathy in association with connective tissue disease is likely caused by circulating autoantibodies to ganglion cell bodies. This is particularly seen in scleroderma or Sjögren syndrome. Numbness begins around the mouth and spreads slowly over months to involve all trigeminal divisions. Frequently, the ophthalmic division is less involved or spared. In Sjögren syndrome, trigeminal ganglionopathy is typically part of a more widespread sensory ganglionopathy.

Metastatic neoplasm or tumors involving the face, such as squamous cell carcinoma, microcystic adnexal carcinomas, and keratoacanthoma, may invade cutaneous nerve branches, especially at their exit point from the skull (mental and infraorbital neuropathies), and exhibit focal sensory loss. The numb chin syndrome (or isolated mental neuropathy) consists of unilateral numbness of the chin and adjacent lower lip and may be an ominous sign of primary or metastatic cancer involving the mandible, skull base, or leptomeninges. The most common etiologies are metastatic breast cancer and lymphoproliferative malignancies.

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