Abstract
Purpose:To discuss how to diagnose and treat a patient with neuropathic pain in the orofacial region by using two cases.
Patients:Case 1: A 57-year-old female with the lesion on the palatal mucosa of the maxillary incisor region. The lesion was diagnosed as Hemangioma and was surgically removed about a year and a half ago at a different department. Though the wound healed well after the operation, patient developed a burning sensation at that area, and presented to our department. Case 2: A 62-year-old female who had an implant placement into the mandibular left second premolar region by a general practitioner. After the surgery, patient started to feel numbness on the left lower lip and the gingival mucosa around the implant. Symptom became worse as light touch on the lower left side of the lip provoked shooting pain, which made her visit our department.
The association of an abnormal sensation (Allodynia,Dysesthesia) with the pain made the diagnosis of traumatic neuropathic pain in both cases. Both cases showed improvement by the pharmacological approach using Pregabalin.
Discussion:The evaluation of an abnormal sensation (Allodynia,Dysesthesia) and performing a diagnostic test with local anesthesia were effective for the diagnosis of neuropathic pain. Treatment can be followed by the guidelines for neuropathic pain which is pharmacological management. However, because of the side effects of the medications has, it is important to select the appropriate medication and use it in the effective dosage which is different from each individual.
Conclusions: The symptom of neuropathic pain in the orofacial region can be improved with the appropriate diagnosis and pharmacological management.
