Sympathetic Activity-Mediated Neuropathic Facial Pain Following Simple Tooth Extraction: A Case Report

Atsushi Kohjitani, Takuya Miyawaki, Keigo Kasuya, Masahiko Shimada

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

This is a report of a case of sympathetic activity-mediated neuropathic facial pain induced by a traumatic trigeminal nerve injury and by varicella zoster virus infection, following a simple tooth extraction. The patient had undergone extraction of the right lower third molar at a local dental clinic, and soon after the tooth extraction, she became aware of spontaneous pain in the right ear, right temporal region, and in the tooth socket. At our initial examination 30 days after the tooth extraction, the healing of the tooth socket was normal; however, the patient had a tingling and burning sensation (dysesthesia) and spontaneous pain of the right lower lip and the right temporal region, both of which were exacerbated by non-noxious stimuli (allodynia). The patient also showed paralysis of the marginal mandibular branch of the facial nerve, taste dysfunction, and increased varicella zoster serum titers. A diagnostic stellate ganglion block (SGB) 45 days after the tooth extraction using one percent lidocaine markedly alleviated the dysesthesia and allodynia. These symptoms are characteristic of neuropathic pain with sympathetic interaction. The patient was successfully treated with SGB and a tricyclic antidepressant.

Original languageEnglish
Pages (from-to)135-138
Number of pages4
JournalCranio
Volume20
Issue number2
Publication statusPublished - Apr 2002

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Tooth Extraction
Facial Pain
Neuralgia
Tooth Socket
Stellate Ganglion
Paresthesia
Hyperalgesia
Temporal Lobe
Trigeminal Nerve Injuries
Dental Clinics
Pain
Human Herpesvirus 3
Third Molar
Chickenpox
Tricyclic Antidepressive Agents
Facial Nerve
Herpes Zoster
Virus Diseases
Lip
Lidocaine

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Sympathetic Activity-Mediated Neuropathic Facial Pain Following Simple Tooth Extraction : A Case Report. / Kohjitani, Atsushi; Miyawaki, Takuya; Kasuya, Keigo; Shimada, Masahiko.

In: Cranio, Vol. 20, No. 2, 04.2002, p. 135-138.

Research output: Contribution to journalArticle

Kohjitani, Atsushi ; Miyawaki, Takuya ; Kasuya, Keigo ; Shimada, Masahiko. / Sympathetic Activity-Mediated Neuropathic Facial Pain Following Simple Tooth Extraction : A Case Report. In: Cranio. 2002 ; Vol. 20, No. 2. pp. 135-138.
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