Trigeminal neuralgia versus atypical facial pain

Author(s):  
Jens C. Türp ◽  
John P. Gobetti
2000 ◽  
Vol 5 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Allan S Gordon

Practitioners are often presented with patients who complain bitterly of facial pain. The trigeminal nerve is involved in four conditions that are sometimes mixed up. The four conditions - trigeminal neuralgia, trigeminal neuropathic pain, postherpetic neuralgia and atypical facial pain - are discussed under the headings of clinical features, differential diagnosis, cause and treatment. This article should help practitioners to differentiate one from the other and to manage their care.


1999 ◽  
Vol 91 (6) ◽  
pp. 1968-1968 ◽  
Author(s):  
Masako Iseki ◽  
Hiromasa Mitsuhata ◽  
Yutaka Tanabe ◽  
Toyo Miyazaki

2013 ◽  
Vol 5;16 (5;9) ◽  
pp. E537-E545
Author(s):  
Mark C. Kendall

Background: Patients presenting with facial pain often have ineffective pain relief with medical therapy. Cases refractory to medical management are frequently treated with surgical or minimally invasive procedures with variable success rates. We report on the use of ultrasound-guided trigeminal nerve block via the pterygopalatine fossa in patients following refractory medical and surgical treatment. Objective: To present the immediate and long-term efficacy of ultrasound-guided injections of local anesthetic and steroids in the pterygopalatine fossa in patients with unilateral facial pain that failed pharmacological and surgical interventions. Setting: Academic pain management center. Design: Prospective case series. Methods: Fifteen patients were treated with ultrasound-guided trigeminal nerve block with local anesthetic and steroids placed into the pterygopalatine fossa. Results: All patients achieved complete sensory analgesia to pin prick in the distribution of the V2 branch of the trigeminal nerve and 80% (12 out of 15) achieved complete sensory analgesia in V1, V2, V3 distribution within 15 minutes of the injection. All patients reported pain relief within 5 minutes of the injection. The majority of patients maintained pain relief throughout the 15 month study period. No patients experienced symptoms of local anesthetic toxicity or onset of new neurological sequelae. Limitations: Prospective case series. Conclusion: We conclude that the use of ultrasound guidance for injectate delivery in the pterygopalatine fossa is a simple, free of radiation or magnetization, safe, and effective percutaneous procedure that provides sustained pain relief in trigeminal neuralgia or atypical facial pain patients who have failed previous medical interventions. Key words: Trigeminal nerve, ultrasound-guided, atypical facial pain, trigeminal neuralgia, tic douloureux.


Neurosurgery ◽  
2003 ◽  
Vol 53 (5) ◽  
pp. 1164-1167 ◽  
Author(s):  
Kim J. Burchiel

Abstract PURPOSE A patient-oriented classification scheme for facial pains commonly encountered in neurosurgical practice is proposed. CONCEPT This classification is driven principally by the patient's history. RATIONALE The scheme incorporates descriptions for so-called “atypical” trigeminal neuralgias and facial pains but minimizes the pejorative, accepting that the physiology of neuropathic pains could reasonably encompass a variety of pain sensations, both episodic and constant. Seven diagnostic labels result: trigeminal neuralgia Types 1 and 2 refer to patients with the spontaneous onset of facial pain and either predominant episodic or constant pain, respectively. Trigeminal neuropathic pain results from unintentional injury to the trigeminal nerve from trauma or surgery, whereas trigeminal deafferentation pain results from injury to the nerve by peripheral nerve ablation, gangliolysis, or rhizotomy in an intentional attempt to treat either trigeminal neuralgia or other facial pain. Postherpetic neuralgia follows a cutaneous herpes zoster outbreak (shingles) in the trigeminal distribution, and symptomatic trigeminal neuralgia results from multiple sclerosis. The final category, atypical facial pain, is synonymous with facial pain secondary to a somatoform pain disorder. Atypical facial pain can be suspected but not diagnosed by history and can be diagnosed only with detailed and objective psychological testing. CONCLUSION This diagnostic classification would allow more rigorous and objective natural history and outcome studies of facial pain in the future.


2012 ◽  
pp. 398-413
Author(s):  
Trang Nguyen ◽  
Pablo F. Recinos ◽  
Michael Lim

Author(s):  
Patricia Sylla

Anatomy and physiology of pain 186 Anatomy and physiology of oro-facial pain 187 Oro-facial (idiopathic) pain syndromes 188 Overview of oro-facial pain 190 Assessment and measurement of pain 192 Temporomandibular dysfunction (TMJPDS) 196 Atypical facial pain 202 Trigeminal neuralgia ('tic douloureux') 204 Glossopharyngeal neuralgia 206...


1994 ◽  
Vol 3 (6) ◽  
pp. 323-329
Author(s):  
G. J. Schmid ◽  
R. M. M. Seibel ◽  
D. H. W. Grönemeyer ◽  
P. Van Leeuwen

2006 ◽  
Vol 64 (4) ◽  
pp. 983-989 ◽  
Author(s):  
Manoel J. Teixeira ◽  
Silvia R.D.T. Siqueira ◽  
Gilberto M. Almeida

OBJECTIVE: To determine the outcomes of 354 radiofrequency rhizotomies and 21 neurovascular decompressions performed as treatment for 367 facial pain patients (290 idiopathic trigeminal neuralgia, 52 symptomatic trigeminal neuralgia, 16 atypical facial pain, 9 post-herpetic neuralgia). METHOD: Clinical findings and surgery success rate were considered for evaluation. A scale of success rate was determined to classify patients, which considered pain relief and functional/sensorial deficits. RESULTS: Radiofrequency rhizotomy was performed in 273 patients with idiopathic trigeminal neuralgia and in all other patients, except for trigeminal neuropathy; neurovascular decompression was performed in 18 idiopathic trigeminal neuralgia patients; 100% idiopathic trigeminal neuralgia, 96.2% symptomatic trigeminal neuralgia, 37.5% atypical facial pain and 88.9% post-herpetic neuralgia had pain relief. CONCLUSION: Both techniques for idiopathic trigeminal neuralgia are usefull. Radiofrequency rhizotomy was also efficient to treat symptomatic facial pain, and post-herpetic facial pain, but is not a good technique for atypical facial pain.


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