Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Myofascial Pain Dysfunction Syndrome: An Update

Abstract

Neuropathic pain is a common phenomenon that affects millions of people worldwide. Maxillofacial structures consist of various tissues that receive frequent stimulation during food digestion. The unique functions (masticatory process and facial expression) of the maxillofacial structure require the exquisite organization of both the peripheral and central nervous systems. Neuralgia is painful paroxysmal disorder of the head-neck region characterized by some commonly shared features such as the unilateral pain, transience and recurrence of attacks, and superficial and shock-like pain at a trigger point. These types of pain can be experienced after nerve injury or as a part of diseases that affect peripheral and central nerve function, or they can be psychological. Since the trigeminal and glossopharyngeal nerves innervate the oral structure, trigeminal and glossopharyngeal neuralgia are the most common syndromes following myofascial pain dysfunction syndrome. Nevertheless, misdiagnoses are common. The aim of this review is to discuss the currently available diagnostic procedures and treatment options for trigeminal neuralgia, glossopharyngeal neuralgia, and myofascial pain dysfunction syndrome.

Association of Serum Serotonin and Pain in Patients with Chronic Low Back Pain before and after Spinal Surgery

“…Moreover, it has been reported that patients with chronic tension type headache may have low levels of serum serotonin [ 42 – 44 ]. These data are supported by the fact that using SSRIs may be associated with improvement of chronic pain [ 45 , 46 ]. Thus, low levels of serotonin may correlate with pain sensitization or perception.…”

Efficacy and Safety of Botulinum Toxin Type A in Treating Patients of Advanced Age with Idiopathic Trigeminal Neuralgia

“…The morbidity of idiopathic trigeminal neuralgia increases with age, patients ≥80 years old account for a large proportion of TN sufferers [ 4 ]. Usually, TN patients are first treated with pharmacological agents [ 5 ]. The pain can be readily managed with medication in approximately 80% of patients.…”

“…Several surgical approaches used to relieve the pain due to TN include neurectomy of the trigeminal nerve branches outside the skull, percutaneous radiofrequency thermal rhizotomy, percutaneous ablation that creates the trigeminal nerve or trigeminal ganglion lesions with heat, percutaneous retrogasserian glycerol rhizotomy, injection of glycerol into the trigeminal cistern, physical compression, trigeminal ganglion balloon microcompression, alcohol injections, botulinum toxin injection, cryotherapy, and gamma-knife radiosurgery (GKRS). Some of the surgical procedures may contribute to some complications [ 5 ], such as hearing loss, facial paresthesia, hypoesthesia, masseter weakness and paralysis, keratitis, transient paralysis of cranial nerves III and VI including diminished corneal reflex, dysesthesia, and anesthesia dolorosa, even an immediate complete loss of vision in one eye after trigeminal radiofrequency rhizotomy due to acute traumatic optic neuropathy.…”

The many faces of genetic contributions to temporomandibular joint disorder: An updated review

“…Patients may often reach an improvement that is 45%‐90% better than their previous clinical painful conditions. The great challenge is to be able to understand and identify the mechanisms involved when treatment fails …”