LAUSR.org creates dashboard-style pages of related content for over 1.5 million academic articles. Sign Up to like articles & get recommendations!

Interventional Management of Refractory Trigeminal Neuropathic Pain: A Prospective Audit of a Novel Management Pathway in 70 Patients.

Photo from wikipedia

BACKGROUND Trigeminal neuropathic pain (TNP) can present as a constant, unremitting unilateral facial pain. Current management is based on expert recommendation that includes pharmacologic agents and psychological therapy. However, treatment… Click to show full abstract

BACKGROUND Trigeminal neuropathic pain (TNP) can present as a constant, unremitting unilateral facial pain. Current management is based on expert recommendation that includes pharmacologic agents and psychological therapy. However, treatment success with pharmacologic management is poor. We adopted a novel strategy that proved to be effective in providing durable relief. OBJECTIVES Prospectively audit a novel strategy in the management of refractory TNP. STUDY DESIGN The authors present a prospective audit of a novel structured management pathway in the treatment of refractory TNP. SETTING Multidisciplinary facial pain clinic at a University Teaching Hospital. METHODS Over a 4-year period, 70 patients with unilateral TNP were prospectively audited at a tertiary care university hospital. Initial treatment was based on pharmacologic therapy while the patient awaited psychological therapy. Patients who failed to respond were offered a novel set of interventions that included ultrasound-guided trigeminal nerve block with depot steroids. RESULTS Patient satisfaction with the novel pathway was high. Only 13 patients (13/70, 18%) responded to standard treatment. Of the 57 patients who were offered the novel intervention, 50 patients consented to undergo the intervention. Forty-two patients (42/50, 84%) reported clinically significant pain relief at 3 months, and 27 patients (27/50, 54%) reported on-going durable relief at 6 months. Treatment failure with the novel intervention was 16%. Out of 54 patients in the employable age, 45 patients (45/54, 83%) were able to maintain gainful employment. LIMITATIONS Open-label, nonrandomized observational design. CONCLUSIONS Standard treatment of TNP is ineffective. The novel set of interventions based on empirical evidence may have a role in managing patients with refractory TNP.

Keywords: management; pain; treatment; audit novel; trigeminal neuropathic; refractory

Journal Title: Pain physician
Year Published: 2020

Link to full text (if available)


Share on Social Media:                               Sign Up to like & get
recommendations!

Related content

More Information              News              Social Media              Video              Recommended



                Click one of the above tabs to view related content.