scholarly journals Characteristics and natural disease history of persistent idiopathic facial pain, trigeminal neuralgia, and neuropathic facial pain

2021 ◽  
Author(s):  
Christian Ziegeler ◽  
Greta Brauns ◽  
Arne May
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Persistent Idiopathic Facial Pain ◽  
History Of

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 Prevalence of Trigeminal Neuralgia in Patients with Chronic Facial Pain in Neurology Lrh Hospital Peshawar.

2021 ◽  
Vol 6 (6) ◽  
pp. 1-7
Author(s):  
Saad Ali ◽  
Zahwa Salam ◽  
Shakir Ullah ◽  
Mehtab Alam ◽  
Harwindar Kumar
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Tooth Extraction ◽  
Age Group ◽  
Cross Sectional ◽  
Maxillary Nerve ◽  
Minimum Age ◽  
History Of ◽  
The Mean ◽  
Hospital Study

Background: Trigeminal Neuralgia (TN) consist of brief periodic but severe and chronic facial pain in acial region in single or multiple branches of the trigeminal nerve. Objective: The objective of this study was to find the prevalence of TN in patients with chronic facial pain. Methodology: This cross sectional observational study was conducted at Department of Neurology OPD Lady Reading Hospital, Peshawar. 46 patients with chronic facial pain were selected for the study. All data was taken on a structured Performa and was entered and analyzed using SPSS version 21. Using non probability consecutive sampling after taking approval from Ethical Committee of the hospital, study duration was 10 months from 25-1-2019 to 25-10-2019. Results: Out of 46 patients, there were 18 (39.1%) males and 28 (60.9%) females. The mean age of the patients was 50.67, the Standard Deviation recorded was 11.56. Minimum age was 21 and maximum age was 67. 23. Out of 31 patients diagnosed with TN had history of tooth extraction and 8 had no extraction. Out of 31 patients presented with TN, right side was involved in 24 (52.2%) patients and left side was involved in 7 (15.2%) patients. Mandibular never was more common in the patients with TN which was 37% followed by maxillary nerve 21.7%, and ophthalmic nerve at 8.7%. Majority of the patients 28 (75.7%) belonged to the age group of 40 to 67. Females having TGN were 78% and males were 50%. Right side (52.2%) was more involved than left side. Mandibular division (37%) was more involved than maxillary and ophthalmic division. Conclusion: We conclude that females are more at risk of developing TN than males. Increasing age has a higher chance of developing TN. Right side is more involved than left. Mandibular division is more involved than maxillary and ophthalmic.

scholarly journals Chronic Facial Pain: Trigeminal Neuralgia, Persistent Idiopathic Facial Pain, and Myofascial Pain Syndrome—An Evidence-Based Narrative Review and Etiological Hypothesis

2020 ◽  
Vol 17 (19) ◽  
pp. 7012
Author(s):  
Robert Gerwin
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Adverse Outcomes ◽  
Neck Muscle ◽  
Neurovascular Compression ◽  
Persistent Idiopathic Facial Pain ◽  
Possible Cause

Trigeminal neuralgia (TN), the most common form of severe facial pain, may be confused with an ill-defined persistent idiopathic facial pain (PIFP). Facial pain is reviewed and a detailed discussion of TN and PIFP is presented. A possible cause for PIFP is proposed. (1) Methods: Databases were searched for articles related to facial pain, TN, and PIFP. Relevant articles were selected, and all systematic reviews and meta-analyses were included. (2) Discussion: The lifetime prevalence for TN is approximately 0.3% and for PIFP approximately 0.03%. TN is 15–20 times more common in persons with multiple sclerosis. Most cases of TN are caused by neurovascular compression, but a significant number are secondary to inflammation, tumor or trauma. The cause of PIFP remains unknown. Well-established TN treatment protocols include pharmacotherapy, neurotoxin denervation, peripheral nerve ablation, focused radiation, and microvascular decompression, with high rates of relief and varying degrees of adverse outcomes. No such protocols exist for PIFP. (3) Conclusion: PIFP may be confused with TN, but treatment possibilities differ greatly. Head and neck muscle myofascial pain syndrome is suggested as a possible cause of PIFP, a consideration that could open new approaches to treatment.

scholarly journals Trigeminal neuralgia and persistent idiopathic facial pain

2012 ◽  
pp. 76-87
Author(s):  
Mark Obermann ◽  
Dagny Holle ◽  
Zaza Katsarava
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Persistent Idiopathic Facial Pain ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
Epidemiologic Evidence ◽  
Clinical Investigations ◽  
Background Pain ◽  
The Face ◽  
Underlying Pathophysiology

Trigeminal neuralgia (TN) and persistent idiopathic facial pain (PIFP) are two of the most puzzling orofacial pain conditions and affected patients often are very difficult to treat. TN is characterized by paroxysms of brief but crucial pain, followed by asymptomatic periods without pain. In some patients a constant dull background pain may persist. This constant dull pain sometimes makes the distinction from PIFP difficult. PIFP is defined as continuous facial pain, typically localized in a circumscribed area of the face, which is not accompanied by any neurological or other lesion identified by clinical examination or clinical investigations. The pain usually does not stay within the usual anatomic boundaries of the trigeminal nerve distribution and is a diagnosis of exclusion. Epidemiologic evidence on TN and even more so on PIFP is quite scarce, but generally both conditions are considered to be rare diseases. The aetiology and underlying pathophysiology of TN and more so PIFP remain unknown. Treatment is based on only few randomized controlled clinical trials and insufficiently evaluated surgical procedures.

scholarly journals Differential Diagnostics of Pain in the Course of Trigeminal Neuralgia and Temporomandibular Joint Dysfunction

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
M. Pihut ◽  
M. Szuta ◽  
E. Ferendiuk ◽  
D. Zeńczak-Więckiewicz
Keyword(s):  
Trigeminal Neuralgia ◽  
Temporomandibular Joint ◽  
Facial Pain ◽  
Differential Diagnostics ◽  
Complex Nature ◽  
Neurogenic Pain ◽  
Temporomandibular Joint Dysfunction ◽  
Medical Specialties ◽  
History Of ◽  
Vascular Pain

Chronic oral and facial pain syndromes are an indication for intervention of physicians of numerous medical specialties, while the complex nature of these complaints warrants interdisciplinary diagnostic and therapeutic approach. Oftentimes, lack of proper differentiation of pain associated with pathological changes of the surrounding tissues, neurogenic pain, vascular pain, or radiating pain from idiopathic facial pain leads to improper treatment.The objective of the paperis to provide detailed characterization of pain developing in the natural history of trigeminal neuralgia and temporomandibular joint dysfunction, with particular focus on similarities accounting for the difficulties in diagnosis and treatment as well as on differences between both types of pain. It might seem that trigeminal neuralgia can be easily differentiated from temporomandibular joint dysfunction due to the acute, piercing, and stabbing nature of neuralgic pain occurring at a single facial location to spread along the course of the nerve on one side, sometimes a dozen or so times a day, without forewarning periods. Both forms differ significantly in the character and intensity of pain. The exact analysis of the nature, intensity, and duration of pain may be crucial for the differential diagnostics of the disorders of our interest.

scholarly journals Peripheral nerve field stimulation for trigeminal neuralgia, trigeminal neuropathic pain, and persistent idiopathic facial pain

Cephalalgia ◽  
2015 ◽  
Vol 36 (5) ◽  
pp. 445-453 ◽  
Author(s):  
Johann Klein ◽  
Sahr Sandi-Gahun ◽  
Gabriele Schackert ◽  
Tareq A Juratli
Keyword(s):  
Trigeminal Neuralgia ◽  
Peripheral Nerve ◽  
Facial Pain ◽  
Symptom Duration ◽  
Field Stimulation ◽  
Trigeminal Neuropathy ◽  
Persistent Idiopathic Facial Pain ◽  
Constant Pain ◽  
Classical Trigeminal Neuralgia ◽  
Peripheral Nerve Field Stimulation

Objective Peripheral nerve field stimulation (PNFS) is a promising modality for treatment of intractable facial pain. However, evidence is sparse. We are therefore presenting our experience with this technique in a small patient cohort. Methods Records of 10 patients (five men, five women) with intractable facial pain who underwent implantation of one or several subcutaneous electrodes for trigeminal nerve field stimulation were retrospectively analyzed. Patients’ data, including pain location, etiology, duration, previous treatments, long-term effects and complications, were evaluated. Results Four patients suffered from recurrent classical trigeminal neuralgia, one had classical trigeminal neuralgia and was medically unfit for microvascular decompression. Two patients suffered from trigeminal neuropathy attributed to multiple sclerosis, one from post-herpetic neuropathy, one from trigeminal neuropathy following radiation therapy and one from persistent idiopathic facial pain. Average patient age was 74.2 years (range 57–87), and average symptom duration was 10.6 years (range 2–17). Eight patients proceeded to implantation after successful trial. Average follow-up after implantation was 11.3 months (range 5–28). Using the visual analog scale, average pain intensity was 9.3 (range 7–10) preoperatively and 0.75 (range 0–3) postoperatively. Six patients reported absence of pain with stimulation; two had only slight constant pain without attacks. Conclusion PNFS may be an effective treatment for refractory facial pain and yields high patient satisfaction.

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