Is there Any Role of Physiotherapy in Fothergill's Disease?

Deepak Anap Subhash M Khatri

doi:10.4172/2157-7595.1000162

Abstract

Background: Fothergill’s Disease (FD) also called as Trigeminal Neuralgia is characterized by paroxysmal attacks of severe, sharp, stabbing, electric shock like pain affecting one side of face mainly second and third divisions of it. FD is sometimes called “the worst pain known to mankind” and “the suicide disorder” by Medical Science. It is trigger by chewing, speaking, cold winds and touching trigger spot. Most of the time the patients with FD who showed partially or refractory responsive to drug therapy they underwent for surgery to relief the pain. Hardly any studies have reported the role of physiotherapy in Fothergill’s Disease. Objective: To find out the effect of physiotherapy management on pain in Fothergill’s Disease. Design: A Pilot Study. Setting: Neuro-Physiotherapy Department, Pravara Rural Hospital, Loni (Bk) - 423 736, Maharashtra State, India. Participants: Patients diagnosed with Fothergill’s Disease. Interventions: Transcutaneous Electrical Nerve Stimulation for 20 minutes, Relaxation Technique (deep breathing exercise) for 10 minutes, hot moist packs for trapezius muscles for 10 minutes, Isometric neck exercises for 5 repetitions on each side. Study duration: Four weeks. Main outcome measure: Visual Analog Scale (VAS) and Brief Pain Inventory-Facial an 18 item Questionnaire Result: Pain was significantly reduce on VAS (p<0.01) and on Brief Pain Inventory- Facial (p<0.01). Conclusion: The results of the study showed that using continuous TENS, Relaxation technique, hot moist pack over the trapezius muscles, Isometric neck exercise reduces pain in Fothergill’s Disease. This pilot study emphasizes role of Physiotherapy in treatment of Fothergill’s Disease.

Highlights

IntroductionReferences to unilateral facial pain causing facial spasms can be seen in the writings of Aretaeus of Cappadocia in the 2nd century A.D. and those of the Arab physician Jujani in the 11th century A.D. The international Association for the study of pain defined Fothergill's Disease as “sudden, usually unilateral, severe, brief, stabbing, recurrent pains in the distribution of one or more branches of the fifth cranial nerve” (Merskey & Bogduk 1994)
Fothergill's Disease (FD) has been referred in the medical literature for centuries
The results of the study showed that using continuous Transcutaneous Electrical Nerve Stimulation (TENS), Relaxation technique, hot moist pack over the trapezius muscles, Isometric neck exercise reduces pain in Fothergill’s Disease

Summary

Introduction

References to unilateral facial pain causing facial spasms can be seen in the writings of Aretaeus of Cappadocia in the 2nd century A.D. and those of the Arab physician Jujani in the 11th century A.D. The international Association for the study of pain defined Fothergill's Disease as “sudden, usually unilateral, severe, brief, stabbing, recurrent pains in the distribution of one or more branches of the fifth cranial nerve” (Merskey & Bogduk 1994). The international Association for the study of pain defined Fothergill's Disease as “sudden, usually unilateral, severe, brief, stabbing, recurrent pains in the distribution of one or more branches of the fifth cranial nerve” (Merskey & Bogduk 1994) People often called it as “Tic douloureux, Trifacial neuralgia, or Trigeminal Neuralgia”. FD is sometimes called “the worst pain known to mankind” and “the suicide disorder” by Medical Science. Any studies have reported the role of physiotherapy in Fothergill’s Disease

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Results

Discussion

Conclusion