Management of Persistent Idiopathic Facial Pain

Abstract

Event Abstract Back to Event Management of Persistent Idiopathic Facial Pain Daniela Adamo1* 1 University of Naples Federico II, Department of Neuroscience, Reproductive Sciences and Dentistry, Italy Persistent idiopathic facial pain (PIFP) is a therapeutic challenge in daily clinical practice because the number of treatment strategies is limited (Benoliel and Gaul, 2017). Psychiatric comorbidity screening is recommended and should be considered in the management plan. Therapeutic trials of PIFP have been reported as efficient but, until now, these have been based on the results of case series and recommendations by experts. Antidepressants and cognitive behaviour therapy provide the best chance of pain relief and an improved quality of life. First line drugs, such as amitriptyline, duloxetine and venlafaxine, and antiepileptics, such as gabapentin or pregabalin, have been considered. These drugs may be prescribed individually or in combination. However, such treatments often have a limited efficacy, with poorly tolerated side effects (Weiss et al., 2017). Other strategies, such as botulinum toxin injections or cannabinoids, are considered as a new treatment route in cases unresponsive to first line drugs. Invasive treatments, such as pulsed radio frequency ablation (PFR) of the sphenopalatine ganglion, peripheral nerve field stimulators (PNFS) and repetitive transcranial magnetic stimulation (rTMS) have also been considered in cases with intractable facial pain (William et al., 2016).