Pathologic fracture of mandibular ramus in a patient with familial dysautonomia: A case report

Familial dysautonomia is a rare disease that impairs the development of sensory nerves, afferent autonomic nerves, and afferent baroreflex pathways. This ultimately results in decreased pain receptors, decreased thermal sensation, blood pressure instability, dysphagia, optic neuropathy, and gait ataxia. The authors are documenting a case of a familial dysautonomia patient who suffered a pathological fracture of the left mandible approximately 4 months after undergoing routine third molar surgery. Due to the patient's inability to perceive pain and lack proprioception, this fracture went undiagnosed until facial swelling was visible. Familial dysautonomia patients require special consideration regarding anesthesia, surgery, and postoperative follow up.