• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.5
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• pp.431-440
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• 2021

Background: Neurovascular compression (NVC) is a well-known cause of trigeminal neuralgia (TN). However, patients with idiopathic TN (ITN) do not have evidence of NVC on magnetic resonance imaging (MRI), and other patients may remain asymptomatic despite evidence of NVC on MRI. This suggests that there may be additional risk factors for TN development other than NVC. Although epidemiological factors, such as age and sex differences, are useful for understanding the pathophysiology of TN, detailed statistics for each TN subtype are currently unavailable. Therefore, this study aimed to classify patients with TN into the following groups based on data extracted from past medical records: classical TN (CTN), secondary TN, and ITN. Methods: The characteristics of the groups and their differences were explored. Results: CTN was more common in women than in men, as previously reported, whereas ITN was more common in men than in women. The ratio of pain sites located on the right side of the face was high in all groups. Patients with CTN were also prone to NVC on the asymptomatic side. Conclusion: By investigating TN subtype, it may be possible to elucidate the pathophysiology of TN. This would greatly improve treatment outcomes.

• The Korean Journal of Pain
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• v.26 no.2
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• pp.177-180
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• 2013

Trigeminal neuralgia (TN) is characterized by recurrent paroxysms of unilateral facial pain that typically is severe, lancinating, and activated with cutaneous stimulation. There are two types of TN, classical TN and atypical TN. The pain nature of classical TN are the same as those described above, whereas atypical TN is characterized by constant, burning pain. We describe the case of a 49-year-old male presenting with right-sided facial pain. The patient was diagnosed with temporomandibular joint disorder at a dental clinic and was on medical treatment, but his symptoms worsened gradually. He was referred to our pain clinic for further evaluation. Radiologic evaluation, including MRI, showed a parapharyngeal tumor. For the relief of TN, a right mandibular nerve (V3) root block was performed at our pain clinic, and then he was scheduled for radiation and chemotherapy.

• Journal of Oral Medicine and Pain
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• v.48 no.1
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• pp.3-10
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• 2023

This review aimed to update our knowledge of the classification, pathophysiology, prognosis, and treatment of trigeminal neuralgia (TN), with the intention of establishing better treatment protocols. The latest version of the International Classification of Headache Disorders uses an etiology-based approach to characterize TN patients, potentially contributing to the development of targeted treatment measures. Noticeable changes in the recent European Academy of Neurology guidelines for the management of TN include the use of magnetic resonance imaging for exclusion of secondary TN and differentiation of idiopathic and classical TN. Additionally, the use of botulinum toxin type A as an addon therapy for mid-term treatment of TN has also been included. Though there has been limited recent progress in the treatment of TN, previous studies emphasize the importance of customized, multidisciplinary management protocols that include drug therapy optimization; provision of continuous education and support; and timely referral of medically refractory patients for surgery in order to achieve favorable prognosis. Furthermore, slow but growing evidence on gene mutations will help elucidate the pathophysiology of TN and contribute to the development of targeted drugs that are effective and safe.

• Journal of Acupuncture Research
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• v.18 no.1
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• pp.50-60
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• 2001

In order to review the studies related to the facial pain by acupuncture, we have referred to a PubMed site by using MeSH searching word of "facial pain and acupuncture". 12 journals with 20 papers were reported on the facial pain and acupuncture. Among them, 4 papers were appeared in Am J Chin Med, 3 in Acupunct Electrother Res, 2 in Br. Dent J, J Orofac Pain and Swed Dent J respectively, and 1 in 7 journals respectively. According to the classification of the patterns, 15 papers were done by clinical studies, 2 by review and meta-analysis respectively, and 1 by experimental study. TMD was the most disease that related to facial pain and CMD, neurogenic facial pain (trigeminal neuralgia, postherpetic pain), dental pain and MPS were also appeared. Most of the studies didn't mention the acupuncture points, L14 Habkok in 4 papers and ST36 Chogsamni in a paper were only mentioned. Various modalities were applied in the trials such as classical acupuncture, electroacupuncture, TENS, SSP and auricular acupuncture. By the above results, we concluded that various acupuncture techniques are used with effectiveness on the facial pain. It would be needed further research on the acupuncture point specific and therapeutic techniques as well.