The Role of Sympathetic Activity in Neuropathic Orofacial Pain

Seventeen patients with neuropathic orofacial pain are presented with reference to precipitating events, pain descriptions, response to treatment, and other aspects of their histories and clinical presentation. Stellate ganglion blocks were done on 14 patients. Ten of 14 patients reported temporary relief of pain with stellate ganglion blocks. Five of these patients noted more prolonged improvement in pain, two reported no change, and two experienced a temporary increase in pain. It is argued that sympathetically maintained pain involving orofacial locations does occur and that stellate ganglion blocks may benefit a subgroup of these patients. It is noted that current diagnostic categories are inadequate to describe a subgroup of these patients. New categories are suggested, and further study is recommended.

orofacial pain; reflex sympathetic dystrophy; neuropathic pain