• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.1
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• pp.67-70
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• 2022

Persistent idiopathic facial pain is a rare and difficult condition to treat. Several pharmacological, nonpharmacological, and invasive treatment options have been used, with varying results. We report the case of a patient with intractable persistent idiopathic facial pain who responded favorably to a combination of botulinum toxin injections and pulsed radiofrequency treatment of the infraorbital nerve.

• Journal of Oral Medicine and Pain
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• v.26 no.2
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• pp.157-160
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• 2001

Facial nerve paralysis(or Bell's palsy) which commonly occurs unilaterally, gives rise to paralysis of facial expression muscle. This condition is classified into symptomatic facial nerve paralysis due to intracranial tumor, post operative trauma, etc. and idiopathic facial nerve paralysis. To explain the etiology of idiopathic facial nerve paralysis, many hypothesis including ischemic theory, viral infection, exposure to cold, immune theory etc. were suggested, but there is no agreement at this point. The method to evaluate the facial nerve paralysis, when it occurs, consists of three stage scale method, image thechnics like CT and MRI, laboratory test to examine the antibody titers of viral infection, neurophysiologic test to evaluate the degree and prognosis of paralysis. Treatment includes medication, stellate ganglion block(SGB), surgery, physical therapy and other home care therapy. In medication, systemic steroids, vitamins, vasodilating-drug and ATP drugs were used. SGB was also used repeatedly to attempt the improvement of circulation and to stimulate the recovery of nerve function. Physical therapy including electric acupuncture stimulation therapy(EAST) and hot pack was used to prevent the muscle atrophy. When No response was showed to this conservative therapies, surgery was considered. After treating two patients complaining of Bell's palsy with medication(systemic steroids) and EAST, favorable result was obtained. so author report the case of facial nerve paralysis.

• The Korean Journal of Pain
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• v.35 no.4
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• pp.458-467
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• 2022

Background: Few studies have investigated unspecified or idiopathic pain associated with COIVD-19. This study aimed to provide the incidence rates of unspecified pain and idiopathic pain in patients with COVID-19 for 90 days after COVID-19 diagnosis. Methods: A propensity score matched cohort was used, including all patients with COVID-19 in South Korea, and analyzed their electronic medical records. The control group consisted of those who had not had tests for COVID-19 at all. Unspecified pain diagnoses consisted of diagnoses related to pain included in the ICD-10 Chapter XVIII. Idiopathic pain disorders included fibromyalgia, temporomandibular joint disorders, headaches, chronic prostatitis, complex regional pain syndrome, atypical facial pain, irritable bowel syndrome, and interstitial cystitis. Results: After matching, the number of participants in each group was 7,911. For most unspecified pain, the incidences were higher in the COVID-19 group (11.7%; 95% confidence interval [CI], 11.0-12.5) than in the control group (6.5%; 95% CI, 6.0-7.1). For idiopathic pain, only the headaches had a significantly higher incidence in the COVID-19 group (6.6%; 95% CI, 6.1-7.2) than in the control group (3.7%; 95% CI, 3.3-4.1). However, using a different control group that included only patients who visited a hospital at least once for any reasons, the incidences of most unspecified and idiopathic pain were higher in the control group than in the COVID-19 group. Conclusions: Patients with COVID-19 might be at a higher risk of experiencing unspecified pain in the acute phase or after recovery compared with individuals who had not had tests for COVID-19.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.326-331
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• 1998

Facial nerve paralysis is a common pain clinical diagnosis. But ipsilateral or contralateral recurrent facial paralysis is found in about 2.6~19.5% of facial paralysis and especially bilateral facial paralysis is rare. While idiopathic facial paralysis is the most common diagnosis, a comprehensive evaluation must be completed prior to this diagnosis in patients with bilateral facial paralysis. A representative case of bilateral alternating facial paralysis treated with stellate ganglion block (SGB) is presented. A 57 years old male patient who had the onset of a right facial paralysis 7 months ago visited pain clinic. Five months after the onset of right facial paralysis, as it was improving, he developed a left facial paralysis. He had history of hypertension, diabetus mellitus and pain episode on mastoid process before facial paralysis developed. Electrical test showed incomplete neuropathy on both side and computed tomography (CT) scan was normal. He was treated with SGB, physical theraphy and aspirin medication. After 25 times SGB, he was recovered almost completely.

• The Korean Journal of Pain
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• v.6 no.2
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• pp.251-254
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• 1993

Hemifacial spasm is a distressing condition characterized by involuntary, intermittent, unilateral twitching of all or parts of the muscles innervated by the facial nerve. This occurrence is most common in middle-aged women. Because etiology of idiopathic hemifacial spasm has remained undefined, no causative agent nor reliable treatment has been established. This report describes a case of CT guided chemical facial nerve block for the treatment of hemifacial spasm. An injection of small amount(0.1 ml) of alcohol(95%) provided relief of the facial spasms.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.2
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• pp.81-87
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• 2021

Purpose: To profile various clinical characteristics of sleep bruxism (SB) patients with idiopathic facial pain (IFP) in the orofacial region. Materials and Methods: We analyzed 28 SB patients among 210 patients with IFP complaints. The profiles were evaluated using patient charts including gender, age, pain duration, pain location, pain intensity and affected areas by pain. Results: SB with IFP occurred more often in females (85.7%) than males (14.3%). The mean age at presentation was 48.9 years. The most common IFP sites of SB patients were the right maxilla (28.6%) and the right mandible (25.0%). The pain complaints occurred mostly in 2 teeth or areas (50.0%), followed by 1 area (28.6%) and then in ≥ 3 teeth or areas (21.4%). The mean pain intensity was 5.9 on a visual analogue scale from 0 to 10. The pain was spontaneous in 20 patients (71.4%), and the mean pain duration was 24.4 months. Conclusion: Identification of clinical characteristics of SB patients with IFP could be useful in the diagnosis of various IFP patients and beneficial in decreasing unnecessary care to reduce IFP. Further studies with larger number of subjects and extended duration are required for more systemized diagnostic methods and development of future treatment guidelines.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.235-240
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• 1997

Hemifacial spasm is a distressing condition characterized by involuntary, intermittent, unilateral twitching of, all or parts, of the muscles innervated by facial nerve. This ailment is most common among middle-aged women. Neither causative agent nor reliable treatment has been established because etiology of idiopathic hemifacial spasm has remained undefined to date. This report describes two cases of hemifacial spasm treatment by injection of Botulinum toxin. An injection of Botulinum toxin provided relief of hemi facial spasm. Botulinum toxin therapy is an effective and convenient treatment of hemifacialspasm.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.640-651
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• 2022

Clinical studies on neuromodulation intervention for trigeminal neuralgia have not yet shown promising results. This might be due to the fact that the pathophysiology of chronic trigeminal neuropathy is not yet fully understood. Chronic trigeminal neuropathy includes trigeminal autonomic neuropathy, painful trigeminal neuropathy, and persistent idiopathic facial pain. This disorder is caused by complex abnormalities in the pain processing system, which is comprised of the affective, emotional, and sensory components, rather than mere abnormal sensation. Therefore, integrative understanding of the pain system is necessary for appropriate neuromodulation of chronic trigeminal neuropathy. The possible neuromodulation targets that participate in complex pain processing are as follows : the ventral posterior medial nucleus, periaqueductal gray, motor cortex, nucleus accumbens, subthalamic nucleus, globus pallidus internus, anterior cingulate cortex, hypothalamus, sphenopalatine ganglion, and occipital nerve. In conclusion, neuromodulation interventions for trigeminal neuralgia is yet to be elucidated; future advancements in this area are required.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.3
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• pp.159-163
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• 2016

Orofacial pain is a common complaint of patients that causes distress and compromises the quality of life. It has many etiologies including trauma, interventional procedures, nerve injury, varicella-zoster (shingles), tumor, and vascular and idiopathic factors. It has been demonstrated that the sympathetic nervous system is usually involved in various orofacial pain disorders such as postherpetic neuralgia, complex regional pain syndromes, and atypical facial pain. The stellate sympathetic ganglion innervates the head, neck, and upper extremity. In this review article, the effect of stellate ganglion block and its mechanism of action in orofacial pain disorders are discussed.

• The Journal of Internal Korean Medicine
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• v.40 no.3
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• pp.499-505
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• 2019

Oculomotor nerve palsy causes ptosis, limitation of eye movement, diplopia, and facial pain. Despite imaging investigation, the cause of the palsy cannot be established in most cases. We treated a patient with idiopathic oculomotor nerve palsy with acupuncture, electroacupuncture, pharmacopuncture, and Korean medical physical therapy. In this case, the symptoms remarkably improved after 28 days of treatment. This case report suggests that traditional Korean medicine is effective in treating ptosis and limitation of eye movement diagnosed as idiopathic oculomotor nerve palsy.