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Feature Article

Neuropathic orofacial pain: diagnosis and multimodal management

E Russell Vickers

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Abstract

Pain in the orofacial region and involving the trigeminal nerve includes burning mouth syndrome, atypical odontalgia, facial postherpetic neuralgia and trigeminal neuralgia. Treatment is multidisciplinary, including treatment with drugs and natural compounds and psychological and behavioural management. New therapies include neuromodulation, analgesic peptides and autologous stem cells.

Key Points

  • Neuropathic orofacial pain manifests as a disease entity.
  • Typical pain qualities are aching, throbbing, burning and sharp.
  • Secondary phenomena are sympathetically maintained pain and local muscle pain.
  • Pharmacological treatments includes amitriptyline, duloxetine, gabapentin, pregabalin and carbamazepine.
  • Psychological treatment is often required for associated depression and anxiety.
  • Multidisciplinary treatment is the gold standard.

    Picture credit: © Christy Krames.

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