Patients with atypical facial pain frequently describe it as a continuous burning or aching pain, often independent of particular activities or stimuli.(1) It may be caused by a variety of etiologies including myofascial, vascular, neuropathic and local insults (such as an abscess or tumor). Untreated or intractable facial pain is incredibly debilitating and a particular challenge to the physician because numerous factors are often involved.(2) Regardless of the ultimate diagnosis, when the pain is resistant to common therapies, there are few options available. There is increasing discussion regarding the use of peripheral nerve stimulation (PNS) to treat atypical facial pain; however, to date, little has been published in the literature.(3,4) We report a collection of ten patients who were successfully treated for atypical facial pain of various etiologies with peripheral nerve stimulation.

METHODS/DISCUSSION

We describe the results of placing peripheral nerve stimulators in ten patients who were suffering from chronic atypical facial pain. Each patient was considered a candidate for placement of a peripheral nerve stimulator after they failed other treatment options, they were evaluated by a pain psychologist, and they had significant pain relief during a PNS trial. Once the patient was determined to be a candidate, we proceeded with placement of the permanent leads [Medtronic, Minneapolis, MN] and an implantable pulse generator.

RESULTS

Each patient had good results during the PNS trial in order to proceed to permanent placement. The majority of patients had good to excellent results after the permanent leads were placed. They report increased functionality, quality of life and decreased requirement for pain medications.

CONCLUSION

We report the successful use of peripheral nerve stimulation to treat chronic atypical facial pain of various etiologies. Long term follow up and studies of a large number of patients is needed to determine efficacy of this treatment option.