Altered trigeminal pain processing on brainstem level in persistent idiopathic facial pain

Pain ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Christian Ziegeler ◽  
Laura H. Schulte ◽  
Arne May
Keyword(s):  
Facial Pain ◽  
Pain Processing ◽  
Persistent Idiopathic Facial Pain ◽  
Trigeminal Pain

scholarly journals Quantitative sensory testing in trigeminal traumatic neuropathic pain and persistent idiopathic facial pain

2013 ◽  
Vol 71 (3) ◽  
pp. 174-179 ◽  
Author(s):  
Silvia R. D. T. de Siqueira ◽  
Mariana Siviero ◽  
Fábio K. Alvarez ◽  
Manoel J. Teixeira ◽  
José T. T. de Siqueira
Keyword(s):  
Neuropathic Pain ◽  
Facial Pain ◽  
Quantitative Sensory Testing ◽  
Pain Processing ◽  
Sensory Testing ◽  
Pain Thresholds ◽  
Persistent Idiopathic Facial Pain ◽  
Corneal Reflex ◽  
Mechanical Detection ◽  
Mandibular Branch

The objective of this article was to investigate, with a systematic protocol of quantitative sensory testing, patients with persistent idiopathic facial pain (PIFP) and others with trigeminal traumatic neuropathic pain (TTN) compared to controls. Thirty patients with PIFP, 19 with TTN, and 30 controls were evaluated on subjective numbness and dysesthesia and with a systematic protocol of quantitative sensory testing for thermal evaluation (cold and warm), mechanical detection (touch and pinpricks for mechanical pain), superficial pain thresholds, and corneal reflex. We found that PIFP and TTN had numbness and dysesthesia higher than controls (p<0.001 and p=0.003), and that in both of them mechanical pain by pinpricks detection was abnormal intra and extra orally at the mandibular branch (p<0.001). Cold, warm, and tactile detections and pain thresholds were similar among the groups. Corneal reflex was abnormal in TTN (p=0.005). This study supports neuropathic mechanisms involving pain processing in PIFP and that the criterion on absence of sensorial variations in PIFP should be revised.

Comparison of Clinical Symptoms and Magnetic Resonance Angiographic (MRA) Results in Patients with Trigeminal Neuralgia and Persistent Idiopathic Facial Pain. Medium-Term Outcome after Microvascular Decompression of Cases with Positive MRA Findings

Cephalalgia ◽  
2006 ◽  
Vol 26 (3) ◽  
pp. 266-276 ◽  
Author(s):  
A Kuncz ◽  
E Vörös ◽  
P Barzó ◽  
J Tajti ◽  
P Milassin ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Facial Pain ◽  
Clinical Symptoms ◽  
Vascular Compression ◽  
Term Outcome ◽  
Persistent Idiopathic Facial Pain ◽  
Venous Compression ◽  
Imaging Results

To evaluate whether NC could be demonstrated preoperatively, high-resolution magnetic resonance angiography (MRA) was performed in 287 consecutive patients with TN and persistent idiopathic facial pain (PIFP) on a 0.5-T and a 1-T MR unit. Depending on the clinical symptoms, the TN cases were divided into typical TN and trigeminal neuralgia with non-neuralgic interparoxysmal pain (TNWIP) groups. Microvascular decompression (MVD) was performed in 103 of the MRA-positive cases. The patients were followed up postoperatively for from 1 to 10 years. The clinical symptoms were compared with the imaging results. The value of MRA was assessed on the basis of the clinical symptoms and surgical findings. The outcome of MVD was graded as excellent, good or poor. The clinical symptoms were compared with the type of vascular compression and the outcome of MVD. The MRA image was positive in 161 (56%) of the 287 cases. There were significant differences between the clinical groups: 66.5% of the typical TN group, 47.5% of the TNWIP group and 3.4% of the PIFP group were positive. The quality of the MR unit significantly determined the ratio of positive/negative MRA results. The surgical findings corresponded with the MRA images. Six patients from the MRA-negative group were operated on for selective rhizotomy and no NC was found. Venous compression of the trigeminal nerve was observed in a significantly higher proportion in the background of TNWIP than in that of typical TN on MRA imaging (24.1% and 0.8%, respectively) and also during MVD (31.2% and 1.2%, respectively). Four years following the MVD, 69% of the patients gave an excellent, 23% a good and 8% a poor result. The rate of some kind of recurrence of pain was 20% in the typical TN and 44% in TNWIP group. The rate of recurrence was 57% when pure venous compression was present. The only patient who was operated on from the PIFP group did not react to the MVD. The clinical symptoms and preoperative MRA performed by at least a 1-T MR unit furnish considerable information, which can play a role in the planning of the treatment of TN.

Cranial neuralgias and persistent idiopathic facial pain

2020 ◽  
pp. 237-247
Author(s):  
Aydin Gozalov ◽  
Messoud Ashina ◽  
Joanna M. Zakrzewska
Keyword(s):  
Neuropathic Pain ◽  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Orofacial Pain ◽  
Treatment Modalities ◽  
Management Approach ◽  
Trigeminal Neuropathy ◽  
Facial Region ◽  
Persistent Idiopathic Facial Pain ◽  
Chronic Orofacial Pain

Orofacial pain is a complex problem and affects up to 7% of the population. Although trigeminal neuralgia has been considered the prime neuralgic condition in the facial region, other forms of neuropathic pain are now being more frequently recognized and require recognition and a different management approach. Many patients with chronic orofacial pain report numerous comorbidities, such as psychiatric or personality disorders, which significantly affect management. Various pain conditions present in the facial region. Some of them rarely present extra-orally (unless as radiating pain) such as atypical odontalgia or persistent dento-alveolar pain disorder and burning mouth syndrome, whereas others will present in both areas such as classical trigeminal neuralgia, post-traumatic trigeminal neuropathy, trigeminal neuropathy attributed to multiple sclerosis, and persistent idiopathic facial pain. Myofascial pain syndrome related to the muscles of mastication is very common and may also be associated with temporomandibular joint problems. Trigeminal neuralgia and the rarer glossopharyngeal neuralgia are similar in quality and characteristics with specific treatment modalities, but differ in pain location. Trigeminal neuropathic pain is caused most frequently by trauma. If no other diagnostic criteria are fulfilled, a diagnosis of persistent idiopathic facial pain is made. It is crucial for these patients to be managed by multidisciplinary teams.

scholarly journals Near-resolution of persistent idiopathic facial pain with low-dose lumbar intrathecal ziconotide: a case report

2019 ◽  
Vol Volume 12 ◽  
pp. 945-949 ◽  
Author(s):  
Brandon P. Staub ◽  
Gianna Casini ◽  
Edward A. Monaco III ◽  
Raymond F. Sekula Jr ◽  
Trent D. Emerick
Keyword(s):  
Case Report ◽  
Facial Pain ◽  
Low Dose ◽  
Persistent Idiopathic Facial Pain

Predictive role of gnathological techniques for the treatment of persistent idiopathic facial pain (PIFP)

2020 ◽  
Vol 41 (11) ◽  
pp. 3315-3319 ◽  
Author(s):  
H. A. Didier ◽  
A. M. Cappellari ◽  
F. Gaffuri ◽  
M. Curone ◽  
V. Tullo ◽  
...  
Keyword(s):  
Facial Pain ◽  
Persistent Idiopathic Facial Pain ◽  
Predictive Role

scholarly journals Peripheral trigeminal nerve field stimulation

2013 ◽  
Vol 35 (3) ◽  
pp. E10 ◽  
Author(s):  
Alberto Feletti ◽  
Giannantonio Zanata Santi ◽  
Francesco Sammartino ◽  
Marzio Bevilacqua ◽  
Piero Cisotto ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Social Relations ◽  
Nerve Stimulation ◽  
Facial Pain ◽  
Field Stimulation ◽  
Trigeminal Neuropathic Pain ◽  
Persistent Idiopathic Facial Pain ◽  
Pain Reporting ◽  
Peripheral Nerve Field Stimulation

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.

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