Supraorbital Nerve Stimulation Eases Long-Standing Facial Pain

2005 ◽  
Vol 35 (13) ◽  
pp. 67
Author(s):  
BETSY BATES
2013 ◽  
Vol 35 (3) ◽  
pp. E10 ◽  
Author(s):  
Alberto Feletti ◽  
Giannantonio Zanata Santi ◽  
Francesco Sammartino ◽  
Marzio Bevilacqua ◽  
Piero Cisotto ◽  
...  

Object Peripheral nerve field stimulation has been successfully used for many neuropathic syndromes. However, it has been reported as a treatment for trigeminal neuropathic pain or persistent idiopathic facial pain only in the recent years. Methods The authors present a review of the literature and their own series of 6 patients who were treated with peripheral nerve stimulation for facial neuropathic pain, reporting excellent pain relief and subsequent better social relations and quality of life. Results On average, pain scores in these patients decreased from 10 to 2.7 on the visual analog scale during a 17-month follow-up (range 0–32 months). The authors also observed the ability to decrease trigeminal pain with occipital nerve stimulation, clinically confirming the previously reported existence of a close anatomical connection between the trigeminal and occipital nerves (trigeminocervical nucleus). Conclusions Peripheral nerve field stimulation of the trigeminal and occipital nerves is a safe and effective treatment for trigeminal neuropathic pain and persistent idiopathic facial pain, when patients are strictly selected and electrodes are correctly placed under the hyperalgesia strip at the periphery of the allodynia region.


2012 ◽  
Vol 5;15 (5;9) ◽  
pp. E725-E732
Author(s):  
Jackson Cohen

Background: Facial pain occurring after traumatic injury of the facial branches of the trigeminal nerve is a medical condition that is often very difficult to treat. Patients are quite disabled by their symptoms and most therapies are ineffective in relieving this pain. Peripheral nerve stimulation has been used as a treatment to provide pain relief for this type of intractable atypical facial pain. Objective: To describe a minimally invasive peripheral nerve stimulation surgical technique for treating posttraumatic trigeminal neuralgia. Study Design: Case report based on a patient seen in a university setting with posttraumatic trigeminal neuropathic pain who underwent a minimally invasive technique for the placement of a peripheral nerve stimulator. Setting: University-based outpatient clinic. Methods: A patient with a clinical picture suggestive of trigeminal neuropathic pain secondary to trauma involving the V1 and V2 branches of the trigeminal nerve was selected. Conservative management was attempted with no improvement before peripheral nerve stimulation was tried with a minimally invasive surgical technique. We recorded the patient’s subjective assessment of pain and daily function before and after the procedure. Results: Following the procedure, the patient’s pain score decreased approximately 50% and the patient reported a better quality of life with improvement in daily function as well as a more positive outlook on her condition. There were no complications after the procedure and the patient reported no complaints with the device. Limitations: Case report. Conclusions: This surgical technique for placing peripheral nerve stimulators allows for a minimally invasive approach for the treatment of intractable posttraumatic trigeminal neuralgia with potentially less risk of facial nerve damage. This case confirms the need for further studies to be done in the future to prove the safety and effectiveness of this technique. Key Words: Peripheral nerve stimulation, posttraumatic trigeminal neuralgia, neuropathic pain, minimally invasive technique, facial pain.


2021 ◽  
Vol 12 (4) ◽  
pp. 2316-2324
Author(s):  
Raghumahanti Raghuveer ◽  
Sonali Marbate ◽  
Ruchi

Migraine is one of the most common disabling headache disorders which is categorized into two broad types based on the number of headache days. It is called episodic or general migraine if the attacks occur less than 15 days per month, and it is categorized as chronic or transformed migraine if headache occur on 15 or more days per month. This study was conducted to find out the effect of strategy for pain using a modality and strategy using mobilization in reducing disability, frequency and pain in migraine without aura. Thirty-Two subjects were selected based on diagnostic criteria for migraine and divided into two groups. Group A received Cervical Mobilization and Myofascial Release with home exercise program and Group B received Transcutaneous Supraorbital Nerve Stimulation with home exercise program. Visual Analogue Scale, Questionnaire (HIT-6) were recorded as outcome on baseline and after 3 weeks. Results showed significant improvements in both the groups with, p<0.01. Between group comparisons elicited non-significant differences with p˃ 0.05. Following the results, it can be concluded that cervical mobilization and Transcutaneous Supraorbital nerve stimulation can be added as a valuable adjunct to medical management in the treatment of migraine without aura.


2012 ◽  
Vol 1;15 (1;1) ◽  
pp. 27-33 ◽  
Author(s):  
David A. Stidd

Facial pain is a complex disease with a number of possible etiologies. Trigeminal neuropathic pain (TNP) is defined as pain caused by a lesion or disease of the trigeminal branch of the peripheral nervous system resulting in chronic facial pain over the distribution of the injured nerve. First line treatment of TNP includes management with anticonvulsant medication (carbamazepine, phenytoin, gabapentin, etc.), baclofen, and analgesics. TNP, however, can be a condition difficult to adequately treat with medical management alone. Patients with TNP can suffer from significant morbidity as a result of inadequate treatment or the side effects of pharmacologic therapy. TNP refractory to medical management can be considered for treatment with a growing number of invasive procedures. Peripheral nerve stimulation (PNS) is a minimally invasive option that has been shown to effectively treat medically intractable TNP. We present a case series of common causes of TNP successfully treated with PNS with up to a 2 year follow-up. Only one patient required implantation of new electrode leads secondary to electrode migration. The patients in this case series continue to have significant symptomatic relief, demonstrating PNS as an effective treatment option for intractable TNP. Though there are no randomized trials, peripheral neuromodulation has been shown to be an effective means of treating TNP refractory to medical management in a growing number of case series. PNS is a safe procedure that can be performed even on patients that are not optimal surgical candidates and should be considered for patients suffering from TNP that have failed medical management. Key words: Trigeminal neuropathic pain, peripheral nerve stimulation, neuromodulation, intractable pain, facial trauma, postherpetic neuralgia


2019 ◽  
Vol 5 (22;5) ◽  
pp. 447-477
Author(s):  
Ajay Antony

Background: Head and facial pain is a common and often difficult to treat disorder. Routine treatments sometimes fail to provide acceptable relief, leaving the patient searching for something else, including narcotics and surgery. Recently, neuromodulation has been expanding to provide another option. Secondary to its potentially temporary nature and relatively manageable risk profile, several reviews have suggested trialing neuromodulation prior to starting narcotics or invasive permanent surgeries. There is evidence that neuromodulation can make a difference in those patients with intractable severe craniofacial pain. Objectives: To provide a basic overview of the anatomy, epidemiology, pathophysiology and common treatments of several common head and facial disorders. Furthermore, to demonstrate the suggested mechanisms of neuromodulation and the evidence currently existing for the use of neuromodulation. Methods: A comprehensive review was performed regarding the available literature through targeting articles reporting on the use of neuromodulation to treat pain of the head and face. Results: We compiled and discuss the current evidence available in treating head and facial pain. The strongest evidence currently for neuromodulation is for occipital nerve stimulation for migraine, transcutaneous vagal nerve stimulation for migraine and cluster headache, sphenopalatine ganglion microstimulation for cluster headache, and transcutaneous supraorbital and supratrochlear nerve stimulation for migraine. In addition, there is moderate evidence for occipital nerve stimulation in treating occipital neuralgia. Limitations: Neuromodulation has been trialed and is promising in several craniofacial pain disorders; however, there remains a need for large-scale, randomized, placebo-controlled clinical trials to further evaluate the efficacy and safety of most treatments. Much of the current data relies on case reports without randomization or placebo controls. Conclusions: With advancing techniques and technology, neuromodulation can be promising in treating intractable pain of the head and face. Although more randomized controlled trials are warranted, the current literature supports the use of neuromodulation in intractable craniofacial pain. Key words: Neuromodulation, headache, facial pain, craniofacial pain, migraine, cluster headache, trigeminal neuralgia, occipital neuralgia, peripheral nerve stimulator, high cervical spinal cord stimulator, peripheral nerve field stimulator


2021 ◽  
Vol 50 (2) ◽  
pp. 183
Author(s):  
Shally Adhina Putri ◽  
Nina Irawati

ABSTRACTBackground: Gustatory rhinitis is a syndrome that causes symptoms of annoying rhinorrhea, occurring immediately after consuming solid or liquid foods which are hot and /or spicy. Usually starts within a few minutes after the ingestion of the foods involved, and is not associated with itching, sneezing, nasal congestion or facial pain. Purpose: To discuss the pathophysiology and proper management of gustatory rhinitis. Literature Review: Recent studies suggest that gustatory rhinitis is likely associated with phenomenon of neurogenic inflammation. The ingestion of spicy foods  caused  the  stimulation of trigeminal sensory nerve endings located in the upper part of the aerodigestive track. Sensory   nerve stimulation seems to be correlated with an activation of post ganglionic cholinergic muscarinic parasympathetic fibers and sensitive to atropine. Conclusion: The initial management of gustatory rhinitis is avoiding the trigger foods. Using combination of topical steroid and anticholinergic intranasal had been proven more effective to treat the rhinorrhea caused by gustatory rhinitis than administration of single drug. ABSTRAKLatar belakang: Rinitis gustatori adalah sindroma yang menimbulkan gejala rinore yang mengganggu, sesaat setelah mengonsumsi makanan padat atau cair, yang bersifat pedas dan/atau berempah. Biasanya dimulai dalam beberapa menit setelah menelan makanan tersebut, dan tidak disertai dengan gatal, bersin, hidung tersumbat atau nyeri wajah. Tujuan: Untuk membahas patofisiologi dan tatalaksana yang tepat pada rinitis gustatori. Tinjauan Pustaka: Sejumlah studi terbaru mendapatkan rinitis gustatori berkaitan dengan fenomena inflamasi neurogenik. Proses menelan makanan pedas dapat menyebabkan stimulasi ujung saraf sensorik trigeminal yang terletak di jalur aerodigestif bagian atas. Stimulasi saraf sensorik tersebut berkaitan dengan pengaktifan serabut saraf parasimpatik muskarinik kolinergik post ganglion yang sensitif terhadap atropin. Kesimpulan: Tatalaksana awal yang dapat dilakukan untuk mengatasi rinitis gustatori adalah menghindari makanan pemicu. Kombinasi penggunaan antikolinergik intranasal dan steroid topikal, secara profilaksis atau sebagai terapi telah terbukti lebih efektif untuk mengatasi rinore akibat rinitis gustatori dibandingkan pemberian masing- masing obat tersendiri.


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