Trigeminal Neuropathic Pain and Orofacial Neuralgias
In a suspected trigeminal neuralgia scenario, it is important to rule out intracranial lesions (such as a mass or demyelination) as a source of pain through imaging. Intracranial lesion may be suspected if the patient is young, and there are neurologic deficits (e.g., loss of sensation, numbness) and loss of other sensory function including hearing, sight, or smell.
Neuropathic orofacial pain is often accompanied by other pain disorders such as myofascial pain or dental pulpitis. Management of any related disorders that contribute to hypersensitivity of the trigeminal nerve may be necessary to obtain improved relief from pharmacological management.
A multidisciplinary pain team approach is helpful to facilitate success in complex neuropathic pain patients with multiple pain disorders and contributing factors.
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