Research Sources On Face Pain and Treatments

As some in our forum are aware, I have long supported or performed research on behalf of face pain patients. Those of us who are able to focus on emerging research trends may find themselves at a great advantage in building constructive and professional team relationships with doctors -- by being aware of recent or authoritative work going on. In that context, I am cross-posting here, a rather lengthy list of research references that was developed by one of the posters in TNA-Connect, a forum on the site of the Facial Pain Association. I have the author's permission to cross-post.

I would welcome additions to this list. I intend to add it to other book marks on my own website, "Giving Something Back", after I have checked out all the links...

Go in Peace and Power,

Red

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Research is getting really messy as so many doctors are now publishing at conferences and online rather than in wait for semi-annual or annual reviews for journals. A comparison might be TNA wesite versus their Facebook web site. Anyway, without listing hundreds of the new pain pathways and pain management slide shows and articles on the web, here are some for us laymen: Available on Docstoc.com articles on TN, RSD and CRPS

http://www.docstoc.com/ articles:
RSDSA_SlideKit_01062010.pdf "Diagnosis and Treatment Options for Complex Regional Pain

Syndrome (CRPS)" by Johns Hopkins University Division of Pain Medicine. TN seems to have morphed
into RSD and CRPS in the medical journals. Free download after you register.

"Atypical Facial Pain and Sphenoplatine Ganglion Analgesia" Free Power Point slide show after you
register.

http://bja.oxfordjournals.org/content/87/1/117.full Cost $35 and is dated 2001.
"Trigeminal neuralgia—pathophysiology, diagnosis and current treatment" in British Journal of
Anaesthesiologyby University of Liverpool doctor P.R. Eldridge. Good summary in those days but all
this info is now on web sites at Oregan Health & Sciences University and Cedars-Sinai Pain center
among others with much additional newer info at no cost.

Sphenopalatine Ganglion Block for the Treatment of Myofascial Pain of the Head, Neck, and Shoulders
http://journals.lww.com/rapm/Abstract/1998/23010/Sphenopalatine_Ganglion_Block_for_the_Treatment_of.
8.aspx for free abnstract with conclusions or purchase $35 download of the article.


Other free downloads:

http://www.webmd.com/pain-management/guide/nerve-blocks
"Pain Management Guide"

Sphenopalatine Ganglion Block compared with Stellate Ganglion Block in patients with Traumatic
Trigeminal Neuralgia by Zarembinski and Graff-Radford at Cedars-Sinai Pain Center - free abstract
download at http://esp.drzarembinski.com/articles/html/sphenopalatine.html or full article at:
http://en.drzarembinski.com/articles/pdf/AnnualMeeting1009pre.pdf results of nerve block one year
later.

http://www.apmsurgery.com/Procedures/Spenopalatine_Trigeminal_Blocks_and_RF.html Sphenopalatine
and Trigeminal Blocks and Radiofrequency Rhizotomy

http://www.ouch-us.org/chgeneral/surgery/snb.htm provides patient results of nerve blocks.

http://onlinelibrary.wiley.com/doi/10.1097/01.mlg.0000227997.48020.44/abstract
Sphenopalatine Endoscopic Ganglion Block: A Revision of a Traditional Technique for Cluster Headache

http://www.webmd.boots.com/pain-management/news/20100201/new-treatment-for-chronic-pain-condition-crps for article "A New treatment for chronic pain condition CRPS
Single IV drip gives significant pain relief in 50% of Complex Regional Pain Syndrome patients"
By Tim Locke WebMD Health News

http://painsandiego.com/2009/05/26/low-dose-naltrexone-ldn/
"Low Dose Naltrexone “LDN” and Dextromethorphan off label for Pain, RSD, Chronic Fatigue,
Fibromyalgia, MS, Crohn’s Disease" 05/26/2009 — Nancy Sajben MD. Includes patient comments.
Interesting that it is also promoted to detox from opiates.

Hyperbaric Oxygen Therapy (HBOT) is showing commercial success but have not yet found reports by
NIH, AMA and NEMJ. HBOT is widely available at nearly every hospital in the world for wound
treatment and in many doctor offices. The new high tech HBOT chambers are available on line for
about $10k and prices vary at doctor offices from treatments ranging from $50 per hour to $150 per
hour. Articles below describe treatments at 10 or 20 but some go longer. Haven't found info on
insurance coverage on this new old treatment that seems to be going viral on the internet. Again,
remember that everyone responds to treatments differently.

http://en.wikipedia.org/wiki/Hyperbaric_medicine HBOT is recognized by Medicare in the United
States as a reimbursable treatment for 14 UHMS "approved" conditions. A 1-hour HBOT session may cost
between $108 and $250 in private clinics, and over $1,000 in hospitals. U.S. physicians (either M.D.
or D.O.) may lawfully prescribe HBOT for "off-label" conditions such as Lyme Disease, stroke, and
migraines. The slang term, at some facilities, for a cycle of pressurization inside the HBOT chamber
is "a dive". An HBOT treatment for longer-term conditions is often a series of 20 to 40 dives, or
compressions. Again, these dives last for about an hour. Big variations as the market gets going.

http://www.florida-oxygen.com/html/index.php?option=com_content&view=article&id=90:rsd-syndrome-
associated-articles&catid=43:content&Itemid=180 Hyperbaric Oxygenation Therapy: Can it Relieve Your Pain? -an RSD related article. Found HBOT in local neurologist offices under their neurology office web sites but not through internet searches.

By Spiegel treatment center in Palm Harbor, FL:
THE EFFECTIVENESS OF HYPERBARIC OXYGEN THERAPY IN THE TREATMENT OF COMPLEX REGIONAL PAIN SYNDROME

RESULTS: All five patients had resolution of the hyperalgesic pain and swelling with return of normal limb
sensation, temperature, color, strength and function. Two of the five have returned to gainful
employment.

CONCLUSIONS: Hyperbaric Oxygen Therapy reverses the reflex vasomotor disturbances thereby reducing
swelling and enhancing oxygen perfusion of the effected tissues in patients with complex regional
pain syndrome. HBO2 should be considered as a treatment option in patients with this disorder.

http://www.rsdhope.org/Showpage.asp?PAGE_ID=139&PGCT_ID=4528 covers this in more detail and
provideslinks to HBOT sites.

http://neurotalk.psychcentral.com/thread35100.html another forum showing HBOT patient
discussions with some results.

http://journals.lww.com/theneurologist/Abstract/2009/07000/Facial_Pain.1.aspx
Abstract of "Facial Pain" by Graff-Radford, Steven B. DDS*†‡ for free or pay $35 for full report of
this classic medical paper on diagnosing face pain pressing the point that other neurological
problems are often the cause of pain rather than TN. Published in July 2009 in The Neurologist
journal.

http://www.webmd.com/pain-management/guide/pain-management-diagnosing
"Pain Management: Diagnosing the Cause of Pain"

http://www.nationalpainfoundation.org/articles/673/injections overview of nerve block
injections. A much better expanation including a video is available at https://www.cedars-sinai.edu/Patients/Programs-and-Services/Pain-Center/Head-and-Neck-Pain/Sphenopalatine-Blocks.aspx


http://www.lookfordiagnosis.com/faq.php?term=Trigeminal+Nerve+Diseases&lang=1 is the British
equivalent of the TNA Facebook page and/or TNA Connect.

As of 1Feb2011 Cedars-Sinai eliminated their TN Program on their Medical Center web site and
transferred it their new Pain Center. You must look for specific treatments for a wide variety of
neurological problems since they can pinpoint the source of the pain that is often not the

trigeminal nerve.Go to this web site for info on their nerve blocks:
http://www.cedars-sinai.edu/Patients/Programs-and-Services/Pain-Center/Head-and-Neck-Pain/

"Fully Endoscopic Vascular Decompression of the Facial Nerve for Hemifacial Spasm" - a case report
by Joseph B. Eby, M.D.,1 SungTae Cha, M.D.,1 and Hrayr K. Shahinian, M.D.' published in 2001 and now

available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1656858/ and also at:
www.skullbaseinstitute.com

http://www.eurekalert.org/pub_releases/1999-11/CMC-CSBs-291199.php
Cedars-Sinai Skull Base surgeon performs world's first fully endoscopic microvascular decompression
for relief of Trigeminal Neuralgia - 29Nov1999.

http://rsna2005.rsna.org/rsna2005/v2005/conference/event_display.cfm?id=66601&em_id=4404662
Trigeminal MRI after Microvacular Decompression Surgery (the Jannetta Operation) -30Nov 2005.

Sphenopalatine Ganglion Block in Traumatic Trigeminal Neuralgia and the Outcome to
Radiosurgical Ablation-One Year Results by Christopher Zarembinski, Cedars-Sinai Pain Center, et.
al. Congress of Neurological Surgeons - Oct 2009.
www.cns.org

http://www.apmsurgery.com/Before_and_after_procedures.html "What You Need to Know Before and After
SPG Nerve Block Injection Procedures"

http://www.apmsurgery.com/Procedures/Spenopalatine_Trigeminal_Blocks_and_RF.html
"Sphenopalatine and Trigeminal Blocks and Radiofrequency Rhizotomy"

http://www.anesthesiology.uci.edu/pain/procedures_head.html
"Head and Facial Nerve Blocks"

http://bja.oxfordjournals.org/content/97/4/559.full "Intranasal lidocaine 8% spray for second-
division trigeminal neuralgia" from Kitasako University, Dept of Anaesthesiology in June 2007.

"The Efficacy of Sphenopalatine Ganglion Block in the Management of Chronic Cluster Headache"
Interesting that they list replies to the paper by Peter Janetta, John Alksne and other prominent
American neurosurgeons. Samer Narouze, Leonardo Kapural, and Nagy Mekhail. Cleveland Clinic

Foundation, Feb 2006
http://aapm.confex.com/aapm/2006am/techprogram/P1246.HTM
"MR Neurography and Diffusion Tensor Imaging: Origins, History & Clinical Impact of the first 50,000
cases with an Assessment of Efficacy and Utility in a Prospective 5,000 Patient Study Group" by
Aaron Filler, MD, PhD, FRCS, Neurography Institute, Santa Monica, CA available at
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924821/ or www.neurographyinstitute.com as free
download. Published in final edited form as: Neurosurgery. 2009 October ; 65(4 Suppl): A29–A43. doi:10.1227/01.NEU.0000351279.78110.00.

http://hmg.oxfordjournals.org/content/13/8/799.full "A mutation in the nerve growth factor beta
gene (NGFB) causes loss of pain perception" Department of Medical Biosciences, Unit of Clinical and
Medical Genetics, Umeå University, SE-90187 Umeå, Sweden

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Red Wanted to say Thank you for this Info, on face pain and treatment’s .These Web’s sight’s will be useful in helping with my pain, and better understanding in manageing my pain along with Pain Management. Thank You Shirley

You're quite welcome, Shirley... I probably should have posted this more widely on the site, though. in my personal blog, it's not as likely to get distribution.

Regards and best,

Red