NEUROPATHIC FACIAL PAINS
Neuropathic pains arise from an injured pain transmission or modulation system, Surgical intervention or trauma is frequently the cause, For example, trauma to the infraorbital region may lead to numbness or pain in the . distribution of the infraorbital nerve. In oral and maxillofacial surgery, extraction of mandibular third molars carries a slight but measurable risk of nerve damage to the mandibular or lingual nerves. In the majority of these
cases, damage leads to paresthesia, an abnormal sensatic in the dermatome of the affected nerve. Typically, tLis sensation is one of mild numbness or tingling, Loss I sensation may occur’ when the nerve is transected. III a subset “f cases dysesthesia. an’ abnormal. unpleasant result it is often described as a burning or sharp electric shocklike sensation, In tact, \\’Ill’:l a patient ‘ complains of bum ill),: or ~h,HP shocklike pain in the face
or mouth, p.un of neurop.ttluc origm should be included in thc.differcntlal diagnOSiS. It should he appreciated that the oral 1110Stcommon site ot amputation, if one recognizes amputations to include the teeth and the dental pulp (i.c. cndodontlcstS ill phantom limb pain after extremity amputation, “phantom” scn-ations can’
also arise, albeit more rarely, alter dental and pulpal trauma or extraction. ‘europathic pains mav also give rise to the sensation of tooth pain, wluch often I~ J diagnostic dilemma for the dentist. II i customary to refer patients for management of these dhorliers to dentists focusing
on orofucial pain diagnosi .or to the patient’s personal physiclan .or a neurologist.