Neuropathic facial pain

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The existing nosology of cranial-nerve pains does not fully portray the subtle differences between various conditions. However, rather than abandoning many long-established diagnostic terms, this classification retains them, providing detailed definitions for differential diagnoses and their types, subtypes and subforms. Afferent fibres in the trigeminal, intermedius, glossopharyngeal and vagus nerves, in addition to the upper cervical roots via the occipital nerves, convey nociceptive input to central pathways in the brainstem and to the brain areas that process nociception and pain in the head and neck.

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The most widely accepted view is that myelin damage results from irritation of the nerve, usually a blood vessel that causes the nerve to be compressed. Facial pain resulting from unintentional injury to the trigeminal system from facial trauma, oral surgery, ear, nose and throat ENT surgery, root injury from posterior fossa or skull base surgery, stroke, etc. This pain is described as dull, burning, or boring and is usually constant because the injured nerve spontaneously sends impulses to the brain.

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Atypical facial pain AFP is a type of chronic facial pain which does not fulfill any other diagnosis. AFP is usually burning and continuous in nature, and may last for many years. Depression and anxiety are often associated with AFP, which are either described as a contributing cause of the pain, or the emotional consequences of suffering with unrelieved, chronic pain.

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Trigeminal neuralgia say: try-GEM-uh-nuhl noo-RAHL-juh is a very specific kind of facial pain that involves the trigeminal nerve or fifth cranial nerve. It is fairly rare, with only four or five people inaffected. Sometimes, facial pain occurs outside the distribution of the trigeminal nerve.

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It may, for example, result from accidental injury to a branch of the trigeminal nerve by trauma or during surgery; it may also be idiopathic. TNP is typically constant, in contrast to most cases of the commoner trigeminal neuralgia. In some cases, pain may be refractory to pharmacological treatment.

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In the s and s, DBS was widely used to treat patients with medically refractory pain syndromes and was considered safe and effective. Subsequently, 2 clinical trials conducted by the device manufacturer failed to meet predefined efficacy criteria, and FDA approval was not sought. As this decision resulted in a dramatic shift away from further exploration of DBS for intractable pain syndromes, it is important to understand how these trials were conducted.

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Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain. You may initially experience short, mild attacks.

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Study record managers: refer to the Data Element Definitions if submitting registration or results information. A rescue drug, Gabapentin, will be provided for pain control. Patients will taper off the Gabapentin 2 weeks before each scan date.

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The diagnosis and management of facial pain below the eye can be very different dependant on whether the patient visits a dentist or medical practitioner. A structure for accurate diagnosis is proposed beginning with a very careful history. The commonest acute causes of pain are dental and these are well managed by dentists.

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To carry out a literature review on major orofacial neuropathic pains, their differential diagnosis and therapies. Neuropathic pains may be classified as episodic or continuous. They may be unilateral and more infrequently bilateral. They may last for seconds, hours or days and may present as electrical shock or burning pain, favorably responding to pharmacological treatment.

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