Facial Pain Treatment

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Pain over face or jaw is commonly seen in patients, suffering from headache, jaw or ear problems. Routinely, Facial pain or jaw pain is seen by a dentist or neurologist, but in some cases, consultation with a Face Pain management specialist is required.

Some causes of Facial pain or Atypical face pain:

1. Trigeminal neuralgia: It is a chronic neuropathic pain that affects the trigeminal nerve of the face. Trigeminal nerve is the 5th cranial nerve, that carries sensation from face to brain. In cases of damage to Trigeminal nerve from brain to its branches i.e. Ophthalmic nerve, maxillary nerve and mandibular nerve or their sub-branches, there could be severe pain over the face and should immediately consult the Dr. Sanjeev, who is amongst the best doctor for facial pain treatment.

Symptoms of trigeminal neuralgia:

a. History of dental procedure or brain injury.
b. Sudden episodes of severe, shooting or jabbing pain that may feel like an electric shock over face, lasting a few seconds.
c. Spontaneous attacks of pain or attacks triggered by things such as touching the face, chewing, speaking or brushing teeth.
d. Constant aching, burning feeling over face and jaw/ear area that sometimes convert into spasm-like pain of trigeminal neuralgia.
e. Pain in areas supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead.

Diagnosis is by clinical feature followed by MRI brain CISS sequence to rule out aberrant artery compression over trigeminal nerve root in the brain or AVM or tumour.

Face Pain Treatment: depends upon severity of symptoms, and range from medications, Peripheral nerve block or neurolysis (mental nerve block, inferior alveolar nerve block, infra-orbital nerve block, supra-orbital nerve block, mandibular nerve block, maxillary nerve block), Trigeminal nerve/ ganglion RFA- Radiofrequency Ablation, Percutaneous Balloon compression PBC of trigeminal ganglion.

2. Glossopharyngeal neuralgia or Eagle's syndrome or Stylagia: It occurs due to compression/ injury of glossopharyngeal nerve, during its course from throat to brain. Common causes are post-tonsillectomy or throat trauma, ear surgery, elongated styloid process or calcified styloid process, etc.

Symptoms of Stylagia:
a. Foreign body sensation in the throat or feeling of something stuck in the throat with repeated desire to clear the throat.
b. Pain over upper neck, lower jaw area with pain in throat, inside ear.
c. Dull-aching pain, or burning pain or shooting pain from jaw to throat.
d. Pain increases on neck rotation.
e. Buzzing sound in ears.
f. Difficulty in swallowing.

3. Sphenopalatine Neuralgia or Sluder's Neuralgia or Atypical face pain: Some patients suffer from mix features of headache (migraine or cluster headache), dull-aching pain over face, dental problems, pain over temple area (above ear region), nasal discharge or facial sweating with pain, anxiety, depression. These features are due to involvement of autonomic ganglion located below maxilla bone in face, known as sphenopalatine ganglion.
Treatment is a diagnostic block followed by sphenopalatine ganglion RFA.

4. Post herpetic Neuralgia PHN of trigeminal nerves: Infection of one of the branches of trigeminal nerve by Herpes zoster virus, causes nerve damage and produces electric-shock like paroxysmal pain over face, like trigeminal neuralgia. Treatment is a diagnostic block followed by Trigeminal nerve/ ganglion RFA.

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