Persistent idiopathic facial pain, a diagnosis and treatment of challenge. Case report

Abstract

BACKGROUND AND OBJECTIVES: Persistent idiopathic facial pain is a chronic disease with neuropathic origin, whose etiology is usually unknown; it is a medical condition that does not respond satisfactorily to drug therapy. It is also a disease with a major impact on patient quality of life and difficult to diagnose. This study aimed to report the diagnosis of a complex, persistent idiopathic facial pain, the pharmacological intervention taken and the adoption of integrative and complementary practices for the management of persistent idiopathic facial, as well as the clinical course and the impact of these actions on the patient's quality of life. CASE REPORT: A female patient, 52, diagnosed 06 years ago as a carrier of persistente idiopathic facial pain associated with bruxism and temporomandibular disorders. The patient presented with a complaint of orofacial pain which did not meet the diagnostic criteria for temporomandibular disorders. The patient also presented myofascial and trigeminal neuralgia pain in the left buccal region which emerged after performing a root canal procedure. The therapeutic plan adopted was based on pharmacological therapy with pregabalin (450mg) in combination with venlafaxine hydrochloride (150mg), continuously. As additional measures, weekly acupuncture sessions, therapy sessions with psychologists, including hypnosis and meditation, as well as peripheral nerve and a venous block during crises and botulinum toxin application were applied. CONCLUSION: The therapeutic plan adopted led to a considerable improvement in the patient's quality of life, evidenced by the reduction in pain intensity and a decrease in the frequency of painful crises. The need for interdisciplinary monitoring, as it is a multifactorial disease, as well as for the ongoing training of various categories of health professionals involved in the treatment of persistent idiopathic facial, given that it is a complication which is rare and difficult to diagnose, is observed.

Persistent idiopathic facial pain associated with borderline personality disorder: a case report

“…1 Furthermore, few controlled studies demonstrated these patients might present a poor clinical response to antidepressant use (e.g., amitriptyline and nortriptyline) and improved quality of life when associated with psychotherapy. 2 Association of PIFP and depression, anxiety symptoms, and poor quality of life are well documented in previous studies, although only a few studies about personality traits were performed. A set of stable individual characteristics (i.e., specific functioning patterns) is formed by a set of stable individual characteristics with a personal manner of perceiving oneself, other people, and life events.…”