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Atypical Facial Pain

Jimoh Agbaje, Antoon De Laat, Politis Constantinus, Peter Svensson, Lene Baad-Hansen
Qualitative somatosensory testing (QualST) is a simple chairside test. It can be used to roughly assess the presence or absence of altered somatosensory function. To use QualST clinically, it is important to assess its agreement with quantitative sensory testing (QST). The aims of this study were to assess the agreement between QST and QualST when testing the modulation of facial sensitivity by capsaicin in healthy participants and to explore the agreement between QST and QualST in assessing the intraoral sensory function in clinical atypical odontalgia (AO) patients...
October 22, 2016: Journal of Oral Rehabilitation
Mark McInturff, Anne Adamson, Chadwick Donaldson, Brenda L Nelson
A 19 year old female presents to the emergency room with right facial enlargement. Clinical examination revealed a soft tissue mass of the right buccal mucosa. Treated initially as infection, the patient later turned to clinic with now rapidly enlarging and intermittently painful mass. Computed tomography with contrast showed a low attenuated buccal mass with mild enhancement lateral to the right caudal maxilla and superior mandible. Biopsy was performed and microscopic examination showed cells with moderate pleomorphism with numerous atypical mitotic figures and occasional elongated "strap" cells with eccentric nuclei...
October 14, 2016: Head and Neck Pathology
Adrienne M Laury, Sarah N Bowe, Joshua Stramiello, Kevin C McMains
OBJECTIVES/HYPOTHESIS: To determine the primary diagnoses for which balloon catheter dilation (BCD) of sinus ostia is being employed in a profit-blind health care system, the Department of Defense. STUDY DESIGN: Retrospective chart review. METHODS: From January 1, 2011 to December 31, 2013, 319 consecutive patient charts were reviewed for International Classification of Diseases, Ninth Edition (ICD-9) diagnoses, presence of chronic rhinosinusitis (CRS) defined by the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS), preoperative Lund-Mackay scores, nasal endoscopy findings, sinuses dilated, postoperative outcomes, and complications...
September 23, 2016: Laryngoscope
Ilker Coven, Ezher H Dayısoylu
BACKGROUND: The sphenopalatine ganglion (SPG) may be involved in persistent idiopathic facial pain and unilateral headaches. The role of SPG blockade via intra oral route in the management of trigeminal neuralgia (TN) is worthy of study. METHODS: In this retrospective study, patient records included patients with atypical TN (type 2) that persisted in spite of conservative treatment for at least 2 years, and an average pain intensity from the craniofacial region visual analogue scale (VAS) before examination...
2016: SpringerPlus
Fang Yu, Florence Chiang, Carlos Bazan
A 30-year-old male presented with left facial pain and numbness. Initial MRI demonstrated an enhancing mass involving the left trigeminal nerve. Follow-up imaging showed interval growth with erosion of the sphenoid body. Surgical resection was performed and immunohistochemistry staining was consistent with an atypical teratoid/rhaboid tumor. Awareness of this entity and its imaging features such as diffusion restriction, intratumoral hemorrhage, and bony destruction, can help guide confirmatory diagnostic testing and appropriate therapy...
June 22, 2016: Neuroradiology Journal
Shervin Rahimpour, Shivanand P Lad
Atypical neuropathic facial pain is a syndrome of intractable and unremitting facial pain that is secondary to nociceptive signaling in the trigeminal system. These syndromes are often recalcitrant to pharmacotherapy and other common interventions, including microvascular decompression and percutaneous procedures. Herein, the authors present two other viable approaches (nucleus caudalis dorsal root entry zone lesioning and motor cortex stimulation), their indications, and finally a possible treatment algorithm to consider when assessing patients with atypical facial pain...
July 2016: Neurosurgery Clinics of North America
Joanna M Zakrzewska
Persistent or chronic idiopathic facial pain, often called atypical facial pain, is often used as a diagnosis of exclusion. It is chronic pain in a nonanatomically distributed area of the face and mouth that can be episodic or continuous and described as a nagging dull pain that at times is severe. It is associated with other chronic pain conditions, psychological abnormalities, and significant life events. Investigations are all normal and early treatment can prevent chronicity. A multidisciplinary biopsychosocial approach with the use of antidepressants and cognitive behavior therapy provides the best chance of pain relief and improved quality of life...
July 2016: Neurosurgery Clinics of North America
Mehmet Ali Duman, Nilgün Selçuk Duru, Bahar Çalışkan, Hale Sandıkçı, Ferhat Çengel
BACKGROUND: Henoch-Schönlein Purpura (HSP) is a systemic hypersensitivity disease of unknown cause that is characterized by a purpuric rash and systemic manifestations, such as colicky abdominal pain, polyarthralgia, and acute glomerulonephritis. Common complications of HSP that lead to surgical intervention include intussusception, perforation, necrosis, and massive gastrointestinal bleeding. Unusual clinical manifestations of HSP may include edema of the scrotum and eyes. Lumbar swelling is rarely seen as a complication of HSP...
May 2016: Balkan Medical Journal
Radhika Besta, Y Uday Shankar, Ashwini Kumar, E Rajasekhar, S Bhanu Prakash
Trigeminal Neuralgia (TN) is considered as one of the most painful neurologic disorders affecting oro-facial region. TN is often diagnosed clinically based on the patients complete history of pain (severity, duration, episodes etc), relief of pain on test dose of Carbamazepine, regional block of long acting anaesthetic. However, Magnetic Resonance Imaging (MRI) plays an important and confirmatory role in showing Neuro Vascular Conflict (NVC) which is the commonest causative factor for TN. This article reviews the effectiveness of three-dimensional constructive interference in steady-state (3D-CISS) MRI in diagnosing the exact location, degree of neurovascular conflict responsible for classical as well as atypical TN and possible pre-treatment evaluation and treatment outcome...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Nicola Benedetto, Paolo Perrini
The sphenopalatine ganglion (SPG) has been assumed to be involved in the genesis of several types of facial pain, including Sluder's neuralgia, trigeminal neuralgia, persistent idiopathic facial pain, cluster headache, and atypical facial pain. The gold standard treatments for SPG-related pain are percutaneous procedures performed with the aid of fluoroscopy or CT. In this technical note the authors present, for the first time, an SPG approach using the aid of a neuronavigator.
April 22, 2016: Journal of Neurosurgery
Yves Yamgoue, Etienne Pralong, Marc Levivier, Jocelyne Bloch
We report the successful treatment of recurrent facial pain by deep brain stimulation (DBS) of the ventroposteromedial thalamic nucleus (VPM-DBS), 10 years after VPM thalamotomy. A 62-year-old woman who suffered from an atypical right-sided trigeminal neuralgia of the V1 and V2 branches was successfully treated a decade ago with a radiofrequency VPM thermocoagulation. Ten years later, the same burning right-sided trigeminal pain progressively recurred and was resistant to medical treatments. A DBS procedure was proposed to the patient aiming to stimulate the vicinity of the preexisting stereotactic lesion...
2016: Stereotactic and Functional Neurosurgery
Kunal Gupta, Kim J Burchiel
BACKGROUND: Pain is a very commonly reported symptom and often drives patients to seek medical attention; however, it can prove a very difficult diagnostic conundrum and even more challenging to treat effectively. Accurately determining the primary pain generator is key, as certain conditions have efficacious medical and surgical treatments. We present a rare case of a man with multiple sclerosis presenting with spinal cord seizures causing dermatomal pain. While pain has been reported in the context of motor symptoms attributed to spinal cord seizures in a small number of spinal cord conditions, this case represents the first report of pain exclusively associated with spinal cord demyelination in multiple sclerosis...
2016: Journal of Medical Case Reports
Ashley Ferro, Shadi Basyuni, Vijay Santhanam
INTRODUCTION: Silent sinus syndrome (SSS) is a rare disorder with protean manifestations. An absence of familiarity with ambiguous and atypical presentations may complicate diagnosis and delay management. CASE PRESENTATION: A 28year old female patient presented with a chronic history of headache, post-nasal discharge and recurrent facial pain refractory to analgesics. Enophthalmos and hypoglobus progressed over a period of 2 months, and a diagnosis of SSS was confirmed via imaging...
2016: International Journal of Surgery Case Reports
María-Luz Cuadrado, Héctor García-Moreno, José-Antonio Arias, Juan A Pareja
OBJECTIVE: Atypical odontalgia (AO), a subform of persistent idiopathic facial pain, is defined as a continuous toothache in which a thorough examination reveals no dental pathology. AO is believed to be a neuropathic condition, given that some cases are preceded by dental procedures. Different topical and systemic medications have been used for the treatment of AO, but their effect is often unsatisfactory. The authors aimed to assess the effect and safety of botulinum neurotoxin type-A (BoNTA) in a series of patients with AO...
September 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Courtney Y Kauh, Lindell R Gentry, Gregory K Hartig, Mark J Lucarelli
Tearing is a frequently encountered chief complaint in an ophthalmologist's office. Certain associated atypical symptoms may warrant further workup. The authors present a case of a patient presenting with painful tearing which elicited further evaluation with CT imaging. This revealed a maxillary sinus fungus ball as the cause for the patient's tearing.
April 4, 2016: Ophthalmic Plastic and Reconstructive Surgery
Dídac Sotorra-Figuerola, Alba Sánchez-Torres, Eduard Valmaseda-Castellón, Cosme Gay-Escoda
BACKGROUND: To determine the clinical characteristics of Continuous Neuropathic Orofacial Pain in patients that suffer Persistent Idiopathic Facial Pain (PIFP), Painful Post-Traumatic Trigeminal Neuropathy (PPTTN) or Burning Mouth Syndrome (BMS) and to describe their treatment. MATERIAL AND METHODS: A retrospective observational study was made, reviewing the clinical history of the patients diagnosed with Continuous Neuropathic Orofacial Pain between 2004 and 2011 at the Orofacial Pain Unit of the Master of Oral Surgery and Implantology of the University of Barcelona and at the Orofacial Pain Unit of the Teknon Medical Center of Barcelona...
April 2016: Journal of Clinical and Experimental Dentistry
Caroline Cluzel, Abdelkerim Ahamat Aboulmali, Stéphanie Dugas, Pascaline Pey, Julien Olive, Carolyn Gara-Boivin
Two adult male castrated dogs were evaluated for progressive paraparesis and ataxia. Neurologic examination showed severe ataxia, delayed proprioceptive placement in the pelvic limbs, pain upon palpation of the lumbar spine as well as facial paresis in one dog, and decreased withdrawal reflex of the pelvic limbs in the other dog. Magnetic resonance imaging (MRI) in both dogs showed diffuse meningeal and intramedullary lesions. However, no evidence of a mass was found. Biopsies could not be performed safely due to the location of the lesions...
March 2016: Veterinary Clinical Pathology
Priva A Randhawa, Lara Cooke, Michael D Hill
No abstract text is available yet for this article.
May 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Mert Akbas, Emel Gunduz, Suat Sanli, Arif Yegin
PURPOSE: There are various facial pain syndromes including trigeminal neuralgia, trigeminal neuropathic pain and atypical facial pain syndromes. Effectiveness of the pulsed radiofrequency in managing various pain syndromes has been clearly demonstrated. There are a limited number of studies on the pulsed radiofrequency treatment for sphenopalatine ganglion in patients suffering from face and head pain. The purpose of this study is to evaluate the satisfaction of pulsed radiofrequency treatment at our patients retrospectively...
January 2016: Brazilian Journal of Anesthesiology
N Cordero Tous, J de la Cruz Sabido, A M Román Cutillas, E J Saura Rojas, A M Jorques Infante, G Olivares Granados
INTRODUCTION: An overview of the effectiveness of radiosurgery in patients diagnosed with trigeminal neuralgia with an analysis of potential predictors of good outcome. METHODS: All patients treated with linear accelerator radiosurgery between 2004 and 2011 were analysed. A dose of 60Gy dose was administered 1 to 2mm from the root entry zone with a maximum isodose of 20% delivered to the brainstem. Clinical results for pain control and any side effects were analysed at 12 and 36 months (BNI score)...
December 14, 2015: Neurología: Publicación Oficial de la Sociedad Española de Neurología
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