{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T21:09:34Z","timestamp":1770412174490,"version":"3.49.0"},"reference-count":6,"publisher":"IMR Press","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Hosp Med"],"published-print":{"date-parts":[[2009,7]]},"abstract":"<jats:p>An 84-year-old Caucasian woman was referred by her primary care dentist to the authors' department with progressive lower lip numbness of 2 months' duration initially noticed by the patient during toothbrushing. The paraesthesia was initially intermittent but became permanent within 1 month. The patient had not sustained any injury to the jaws and no dental treatment had been provided before symptoms started. A course of empirical antibiotics had no impact.<\/jats:p>\n                  <jats:p>She was previously diagnosed with hypertension, ischaemic heart disease and atrial fibrillation for which she was prescribed lisinopril, valsartan, atorvastatin, digoxin and warfarin. She had no known allergies. She was a non-smoker and drank alcohol occasionally. She was the main carer for her husband who suffers from multiple sclerosis.<\/jats:p>\n                  <jats:p>Clinical examination revealed reduced sensation to light touch and pinprick in the distribution of the left mental nerve. No other cranial nerve abnormalities were noted. Apart from mild tenderness in the left buccal sulcus opposite the lower left first premolar and a polyp-like lesion on the lower left lip, no other intraoral abnormalities were found.<\/jats:p>\n                  <jats:p>Initial blood tests including full blood count, haematinics, liver and renal function, glucose, erythrocyte sedimentation rate and bone profile were performed to rule out possible systemic causes of mental paraesthesia and were unremarkable. A panoramic radiograph (Figure 1) showed generalized osteoporosis with a loss of the lower border cortex and inferior dental canal outlines bilaterally. Subsequent magnetic resonance imaging (Figure 2) revealed extensive T1 areas of low marrow signal throughout the skull vault, skull base, cervical vertebrae and the clavicles with the entire left side of mandible showing reduced T1 signal in keeping with mandibular marrow replacement. The appearances were consistent with extensive bone metastatic disease with marrow infiltration of the left side of the mandible involving the mental nerve. Further blood tests revealed normal immunoglobulins and absence of paraprotein.<\/jats:p>\n                  <jats:p>Oncological referral and further investigation including chest X-ray, whole body computed tomography scan and bone marrow aspiration and trephine confirmed a diagnosis of follicular lymphoma.<\/jats:p>","DOI":"10.12968\/hmed.2009.70.7.43131","type":"journal-article","created":{"date-parts":[[2014,5,23]],"date-time":"2014-05-23T09:47:14Z","timestamp":1400838434000},"page":"418-419","source":"Crossref","is-referenced-by-count":0,"title":["An unusual case of acute onset lower lip numbness"],"prefix":"10.31083","volume":"70","author":[{"given":"Anne","family":"Hegarty","sequence":"first","affiliation":[{"name":"Oral Medicine, Unit of Oral Medicine, UCL Eastman Dental Institute and UCLHT, Eastman Dental Hospital, London WC1X 8LD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Hodgson","sequence":"additional","affiliation":[{"name":"Oral Medicine, Unit of Oral Medicine, UCL Eastman Dental Institute and UCLHT, Eastman Dental Hospital, London WC1X 8LD"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","reference":[{"key":"p_11","doi-asserted-by":"publisher","DOI":"10.1016\/S1079-2104(99)70137-X"},{"key":"p_12","doi-asserted-by":"publisher","DOI":"10.1016\/S1040-8428(00)00050-0"},{"key":"p_13","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2008.01.023"},{"key":"p_14","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2007.12.046"},{"key":"p_15","doi-asserted-by":"publisher","DOI":"10.1016\/S1079-2104(99)70136-8"},{"key":"p_16","first-page":"155","volume":"79","author":"Vigano P","year":"2007","journal-title":"Arch Ital Urol Androl"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/pdf\/10.12968\/hmed.2009.70.7.43131","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:17:00Z","timestamp":1770373020000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/70\/7\/10.12968\/hmed.2009.70.7.43131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,7]]},"references-count":6,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2009,7]]}},"alternative-id":["10.12968\/hmed.2009.70.7.43131"],"URL":"https:\/\/doi.org\/10.12968\/hmed.2009.70.7.43131","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,7]]}}}