Transcranial Neurostimulation (rTMS, tDCS) in the Treatment of Chronic Orofacial Pain.
Authors: Fricová J, Rokyta R
Abstract
Although commonly seen in the clinical practice, chronic orofacial pain quite often does not have a clear unambiguous organic origin. It may be difficult to find optimal pharmacotherapy, and in many cases, this pain may become pharmacotherapy resistant. Neuromodulation, particularly with electromagnetic neurostimulation techniques, has been widely used for the treatment of different types of pharmacoresistant pain, and repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) exemplify readily available noninvasive neuromod...
Source: Progress in Neurological Surgery - October 14, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Anatomy of Trigeminal Neuromodulation Targets: From Periphery to the Brain.
Authors: Goellner E, Rocha CE
Abstract
The trigeminal nerve complex is a very important and somewhat unique component of the nervous system. It is responsible for the sensory signals that arise from the most part of the face, mouth, nose, meninges, and facial muscles, and also for the motor commands carried to the masticatory muscles. These signals travel through a very complex set of structures: dermal receptors, trigeminal branches, Gasserian ganglion, central nuclei, and thalamus, finally reaching the cerebral cortex. Other neural structures participate, directly or indirectly, in the transmission and m...
Source: Progress in Neurological Surgery - October 8, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Motor Cortex Stimulation for Facial Pain.
Authors: Teton ZE, Raslan AM
Abstract
Motor cortex stimulation (MCS) has been used in the treatment of intractable neuropathic facial pain for nearly 30 years. While efficacy rates have been noted as high as 88% in some studies, considerable variability in treatment response remains. Additionally, MCS is often cited as providing diminishing relief over time, and there are few long-term studies on efficacy. Complications are generally mild and include infection, hardware complication, seizure, and transient neurological deficit. Despite relatively minimal use, MCS remains a viable treatment option for the a...
Source: Progress in Neurological Surgery - September 30, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Cervical Spinal Cord Stimulation for Facial Pain.
Authors: Jones MR, Baskaran AB, Rosenow JM
Abstract
Neuropathic facial pain can be exceedingly difficult to manage with conventional therapies. Since this pain may be excruciating and often debilitating and some patients do not respond or do not tolerate conventional treatments, the interest in neuromodulation therapies is increasing. One of the most commonly used neuromodulation therapies, spinal cord stimulation, has recently shown promise in treating facial pain. We reviewed the current literature to determine usefulness of spinal cord stimulation in management of refractory facial pain. Our review indi...
Source: Progress in Neurological Surgery - September 15, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
High-Frequency Peripheral Nerve Stimulation for Craniofacial Pain.
Authors: Finch P, Drummond P
Abstract
Since the first successful use of high-frequency electrical stimulation of trigeminal branches for treatment of facial pain in 1962, neuromodulation techniques become well established but remain greatly underutilised. Most subsequent implantation techniques and commercial devices for peripheral nerve stimulation, available until the last decade, utilised frequencies in the range 1-100 Hz. With the commercial introduction of 10-kHz spinal cord stimulation, there has been renewed interest in peripheral applications of kHz frequency neuromodulation. High-frequency biphasi...
Source: Progress in Neurological Surgery - September 11, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Deep Brain Stimulation for Facial Pain.
Authors: Singleton WGB, Ashida R, Patel NK
Abstract
Electro-modulation of subcortical deep brain structures by surgically implanted electrodes is now standard evidence-based treatment for movement disorders such as Parkinson's disease and essential tremor and is approved for dystonia and obsessive-compulsive disorder under a humanitarian exemption. Historically, deep brain stimulation (DBS) for multiple indications has demonstrated acceptable complication rates, rare mortality, and reducing morbidity as the technology and the techniques of its application have advanced. DBS for the amelioration of pain has...
Source: Progress in Neurological Surgery - September 11, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Neurosurgical Management of Cancer Facial Pain.
Authors: Mirzadeh Z, Sheehy JP, Ben-Haim S, Rosenberg WS
Abstract
Facial pain occurs in approximately 80% of patients with head and neck cancers. Pain in these settings may result directly from the tumor, or indirectly as a side effect of oncological treatment of the tumor. Optimizing treatment for cancer pain of the face, therefore, involves a variety of diagnostic and treatment considerations, with the development of a successful treatment algorithm dependent on accurate diagnosis of the anatomical location of the pain, its relationship to the facial pain pathway, the type of pain being treated and, fina...
Source: Progress in Neurological Surgery - August 20, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Peripheral Nerve Stimulation for Facial Pain Using Conventional Devices: Technique and Complication Avoidance.
Authors: Mogilner AY
Abstract
The introduction of peripheral neuromodulation to treat headache and facial pain two decades ago opened up the field to non-neurosurgical practitioners, given the relatively low risk and technical ease of the procedure. These procedures, primarily occipital nerve stimulation (ONS) and trigeminal branch stimulation such as supra- and infraorbital nerve stimulation, are now established to be effective in a number of facial pain and headache syndromes, despite their lack of approval by regulatory agencies such as the US Food and Drug Administration (FDA). For that reason and othe...
Source: Progress in Neurological Surgery - August 20, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Targeted Drug Delivery (Intrathecal and Intracranial) for Treatment of Facial Pain.
Authors: Dupoiron D
Abstract
Despite the high incidence of facial pain, targeted drug delivery remains a rarely used technique for treatment of otherwise refractory pain. Two distinct paths have been described. The intraventricular route allows direct access to intracerebral opioid receptors. The more recently introduced upper cervical or cisternal intrathecal route, is based on the same theories as classical intrathecal route. Intraventricular route was first described by A.K. Ommaya; its use remains limited, mostly with morphine, despite a high clinical efficiency, probably because of the invasive nature...
Source: Progress in Neurological Surgery - August 20, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Classification of Facial Pain: A Clinician's Perspective.
Authors: Hupe CAG, Slavin KV
Abstract
Successful management of facial pain starts with making correct diagnosis. Diagnostic errors, particularly early on in evaluation of facial pain patients are not uncommon, and some of this may be related to the lack of uniform classification that would satisfy needs of different specialists. Here, we critically review several most common classification schemes and try to compare and contrast their strength and unique features. We also attempt to link multiple terminologies describing same clinical conditions and provide a rationale for developing a unified nosological ...
Source: Progress in Neurological Surgery - August 3, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Gasserian Ganglion Stimulation for Facial Pain.
Authors: Yin D, Slavin KV
Abstract
Non-neuralgic trigeminal neuropathic pain can be challenging in terms of treatment as pharmacological interventions often tend to be ineffective. Within the pain-transmitting pathway, the Gasserian ganglion (GG) is a rather unique anatomical and physiological structure where the sensory (including pain) information from the entire half of the face undergoes primary processing in a very compact and clearly defined entity. Moreover, GG is positioned in a completely immobile intradural location (the Meckel's cave) and is insulated from the brain by a layer of dura. As a conf...
Source: Progress in Neurological Surgery - July 31, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Peripheral Nerve Stimulation for Facial Pain Using Wireless Devices.
Authors: Stokey BG, Weiner RL, Slavin KV, Hayek SM
Abstract
Since its original introduction several decades ago, peripheral nerve stimulation (PNS) of the craniofacial region has been traditionally performed using devices intended for spinal cord stimulation applications with inevitably high rate of technical challenges and procedural complications. The lower invasiveness of recently developed wireless neurostimulation systems makes them much better suited for craniofacial applications. Here, we discuss the preliminary clinical data from several published reports and the ongoing multicenter prospective stu...
Source: Progress in Neurological Surgery - July 31, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Transcutaneous Electrical Nerve Stimulation for Facial Pain.
Authors: Zayan K, Felix ER, Galor A
Abstract
Transcutaneous electrical nerve stimulation (TENS) has been used for its analgesic effects for chronic pain, including facial pain. Here, we summarize how the electrical stimulation of branches of the trigeminal nerve via TENS has been utilized to reduce pain resulting from trigeminal neuralgia, temporomandibular joint disorder, migraine and other headache types, and ocular pain sensations. TENS has been used for both short-term (one session) and long-term (multiple sessions) pain control with little to no adverse effects reported by subjects. The results of the...
Source: Progress in Neurological Surgery - July 24, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Sphenopalatine Ganglion Stimulation for Chronic Headache Syndromes.
Authors: Vesper J, Santos Piedade G, Hoyer R, Slotty PJ
Abstract
Neuropathic facial pain is notoriously difficult to treat, regardless of its origin and duration. Since the first reported sphenopalatine ganglion blockade by Sluder in 1908, this ganglion has assumed an important role among the structures targeted for the treatment of facial pain. Recent years have witnessed the rise of neuromodulation over ablative procedures, including the development of an implantable stimulation device specially designed for use in the pterygopalatine fossa. Sphenopalatine ganglion stimulation has been demonstrated as ef...
Source: Progress in Neurological Surgery - July 24, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Transcranial Direct Current Stimulation in the Treatment of Facial Pain.
Authors: Antal A
Abstract
Non-invasive neuromodulation techniques such as transcranial direct current stimulation (tDCS) enable researchers and health care professionals to gain unique insight into brain functions and to treat a number of neurological and psychiatric conditions. Repeated applications of anodal tDCS over the primary motor cortex (M1) have been shown to produce long-lasting relief of neuropathic pain. tDCS is a technique that can induce and modulate brain plasticity and thus be suitable for treating diverse chronic pain conditions, disorders associated with substantial reorganization of cent...
Source: Progress in Neurological Surgery - July 24, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
