<p>Near-resolution of persistent idiopathic facial pain with low-dose lumbar intrathecal ziconotide: a case report</p>

IntroductionBorderline personality disorder may be associated with persistent facial pain since its relationship with different pain syndromes has been reported. Persistent idiopathic facial pain is commonly unilateral, pulsating, burning, or profound and challenging for clinicians. Therefore, excluding underlying organic causes by appropriate clinical investigation and complementary tests is essential to diagnose this disease.Objective This case report aimed to provide evidence of the relationship between idiopathic persistent facial pain and borderline personality disorder.Case report A 24-year-old woman reported severe pain in the left hemiface for ten months, three to six hours per day, five days per week. No abnormalities were found in dental and neurological assessments. A psychiatric evaluation was performed, and the patient met the criteria for borderline personality disorder. Pharmacological treatment consisted of daily lithium carbonate (900 mg) and venlafaxine (150 mg). Weekly sessions of cognitive-behavioral therapy with emotional regulation and tolerance to stress were performed. The patient was evaluated every 30 days and showed improved pain intensity and frequency over six months. Conclusion Proper management of borderline personality disorder can modify the evolution of persistent idiopathic facial pain when both pathologies are comorbidities.

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Sphenopalatine Ganglion Electrical Nerve Stimulation Implant for Intractable Facial Pain

January 2018 - Pain Physician ◽

10.36076/ppj.2015/18/e403 ◽

2015 ◽

Vol 3;18 (3;5) ◽

pp. E403-E409

Author(s):

Foad Elahi

Keyword(s):

Case Report ◽

Pain Relief ◽

Local Anesthetic ◽

Nerve Stimulation ◽

Facial Pain ◽

Pain Clinic ◽

Sphenopalatine Ganglion ◽

Electrical Nerve Stimulation ◽

Persistent Idiopathic Facial Pain ◽

Electrical Neuromodulation

Persistent idiopathic facial pain can be extremely difficult and significantly challenging to manage for the patient and the clinician. Pharmacological treatment of these painful conditions is not always successful. It has been suggested that the autonomic reflex plays an important role in the pathophysiology of headaches and facial neuralgia. The key structure in the expression of cranial autonomic symptoms is the sphenopalatine ganglion (SPG), also known as the pterygopalatine ganglion. The role of the SPG in the pathophysiology of headaches and facial pain has become clearer in the past decade. In this case report, we describe a 30-year-old woman with insidious onset of right facial pain. She was suffering from daily pain for more than 9 years prior to her visit at the pain clinic. Her pain was constant with episodic aggravation without a predisposing trigger factor. The patient was evaluated by multiple specialties and tried multimodal therapy, which included antiepileptic medications, with minimal pain relief. A SPG block using short-acting local anesthetic provided significant temporary pain relief. The second and third attempt of SPG block using different local anesthetic medications demonstrated the same responses. After a thorough psychological assessment and ruling out the presence of a correctable cause for the pain, we decided to proceed with SPG electrical neuromodulation. The patient reported significant pain relief during the electrical nerve stimulation trial. The patient underwent a permanent implant of the neurostimulation electrode in the SPG region. The patient was successfully taken off opioid medication and her pain was dramatically responsive during a 6-month follow-up visit. In this article we describe the SPG nerve stimulation and the technical aspect of pterygopalatine fossa electrode placement. The pterygoplatine fossa is an easily accessible location. This case report will be encouraging for physicians treating intractable facial pain by demonstrating a novel therapeutic option. This report shows a minimally invasive approach to the SPG. Key words: Sphenopalatine ganglion, persistent idiopathic facial pain, electrical neuromodulation

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Resting Tremor during Low-dose Tricyclic Antidepressant Treatment - A case report -

The Korean Journal of Pain ◽

10.3344/kjp.2007.20.1.71 ◽

2007 ◽

Vol 20 (1) ◽

pp. 71

Author(s):

Young Bok Lee ◽

Jong Taek Park ◽

Ja Youn Jeon ◽

Kwang Ho Lee

Keyword(s):

Case Report ◽

Low Dose ◽

Antidepressant Treatment ◽

Tricyclic Antidepressant ◽

Resting Tremor

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Successful Kidney Transplantation After Repeat Desensitization Using Plasmapheresis, Low-Dose Intravenous Immunoglobulin, Rituximab, and Bortezomib in a Highly HLA-Sensitized and ABO Incompatible Patient: A Case Report.

Transplantation Journal ◽

10.1097/00007890-201407151-01505 ◽

2014 ◽

Vol 98 ◽

pp. 453

Author(s):

M. Inui ◽

T. Miyazato ◽

M. Furusawa ◽

K. Tanabe

Keyword(s):

Kidney Transplantation ◽

Case Report ◽

Intravenous Immunoglobulin ◽

Low Dose

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A novel method to treat recurrent facial pain: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02888-1 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Jintakorn Kuvatanasuchati ◽

Karoon Leowsrisook

Keyword(s):

Case Report ◽

Trigeminal Neuralgia ◽

Facial Pain ◽

Case Presentation ◽

Facial Movements ◽

Novel Treatment ◽

Effective Cost ◽

Novel Method

Abstract Background Chronic facial pain is a serious condition affecting millions of people worldwide. The reasons for chronic facial pain vary, and currently, the methods of treating chronic facial pain are expensive, invasive, and, based on current findings, ineffective. The purpose of this study is to develop and test an effective, cost-friendly method to treat patients with chronic facial pain. This study will examine the effectiveness of a novel treatment of a patient suffering from trigeminal neuralgia. Case presentation A 70-year-old Thai female visited the advanced general dentistry clinic at the Faculty of Dentistry, Mahidol University, Bangkok, Thailand. She was suffering from facial pain on her left side and was diagnosed by a physician as having trigeminal neuralgia. She experienced a sharp shooting pain that was triggered by facial movements such as chewing, speaking, or brushing teeth, and touching certain areas of her face. Bouts of pain lasted from a few seconds to several minutes, and episodes of several attacks lasted days, weeks, months, or longer prior to her visit to the advanced general dentistry clinic at Mahidol University. Physician designed an occlusal equilibration appliance for treating the patient by inserting the appliance in the mouth for dental occlusal equilibration (deprogram). The patient used this appliance by placing it in the mouth continuously (day and night) and removed it only when eating. After using the appliance for 2 weeks, the patient appeared to feel and look better prior to taking medication and was able to eat normally. The patient was pain free after treatment for a duration of 9 months. However, after 9 months, the pain reoccurred and manifested itself. Conclusion This novel treatment of recurrent facial pain showed an improvement of the patient’s chronic facial pain and serves as evidence to being a novel method for treating those suffering from trigeminal neuralgia.

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