title: Facial Pain Update: Advances in Neurostimulation for the Treatment of Facial Pain.
abstract: Craniofacial pain, including trigeminal neuralgia, trigeminal neuropathic pain, and persistent idiopathic facial pain, is difficult to treat and can have severe implications for suffering in patients afflicted with these conditions. In recent years, clinicians have moved beyond treating solely with pharmacological therapies, which are generally not very effective, and focused on new interventional pain procedures. These procedures have evolved as technology has advanced, and thus far, early results have demonstrated efficacy in small patient cohorts with a variety of craniofacial pain states. Some of the most promising interventional pain procedures include peripheral nerve field stimulation, high-frequency spinal cord stimulation, sphenopalatine ganglion stimulation, and deep brain stimulation. This review focuses on a better understanding of craniofacial pain and emerging interventional pain therapies. With the advent of newer miniature wireless devices and less invasive implantation techniques, this should allow for more widespread use of neurostimulation as a therapeutic modality for treating craniofacial pain. Larger studies should assist in best practice strategies vis-à-vis traditional pharmacological therapies and emerging interventional pain techniques.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Rajivan
authors.initials: R
authors.lastname: Maniam
authors.affiliation: Department of Anesthesiology, Louisiana State University Medical School, New Orleans, LA, USA.
authors.forename: Alan David
authors.initials: AD
authors.lastname: Kaye
authors.affiliation: Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Nalini
authors.initials: N
authors.lastname: Vadivelu
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. urmanr@gmail.com.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D004599:Electric Stimulation Therapy / Q000379:methods*; D005157:Facial Pain / Q000628:therapy*; D006801:Humans; D059408:Pain Management / Q000379:methods*
keywords: Deep brain stimulation; Facial pain; High frequency spinal cord stimulation; Neurostimulation; Peripheral nerve field stimulation; Persistent idiopathic facial pain; Sphenopalatine ganglion stimulation; Trigeminal neuralgia; Trigeminal neuropathic pain