Abhinaya LM, Muthukrishnan Arvind, Deepika Rajendran. Neuropathic Pain Management in a Tertiary Care Oral Medicine Unit. Int J Dentistry Oral Sci. 2021;8(8):4010-4015.
4010
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Neuropathic Pain Management in a Tertiary Care Oral Medicine Unit
Research Article
International Journal of Dentistry and Oral Science (IJDOS)
ISSN: 2377-8075
*Corresponding Author:
Muthukrishnan Arvind,
Professor and Head, Department of Oral Medicine and Radiology and Special Care Dentistry, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical
Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
Tel: 9444303303
E-mail: arvindm@saveetha.com
Received: July 30, 2021
Accepted: August 11, 2021
Published: August 18, 2021
Citation: Abhinaya LM, Muthukrishnan Arvind, Deepika Rajendran. Neuropathic Pain Management in a Tertiary Care Oral Medicine Unit. Int J Dentistry Oral Sci. 2021;8(8):4010-
4015. doi: http://dx.doi.org/10.19070/2377-8075-21000819
Copyright: Muthukrishnan Arvind
©
2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution and reproduction in any medium, provided the original author and source are credited.
Abhinaya LM
1
, Muthukrishnan Arvind
2*
, Deepika Rajendran
3
1
Department of Oral Medicine and Radiology and Special Care Dentistry, Saveetha Dental College and Hospital, Saveetha Institute of Medical and
Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
2
Professor and Head, Department of Oral Medicine and Radiology and Special Care Dentistry, Saveetha Dental College and Hospital, Saveetha Institute
of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
3
Senior Lecturer, Department of Oral Medicine and Radiology and Special Care Dentistry, Saveetha Dental College and Hospital, Saveetha Institute of
Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
Introduction
Neuropathic pain is defned as pain arising as a direct conse-
quence of a lesion or a disease affecting the somatosensory sys-
tem-The international association for the study of pain (IASP)
special interest group on neuropathic pain [22]. Neuropathic pain
possesses a signifcant challenge to diagnosticians due to the com-
plexity involved and managing the condition appropriately[49].
Neuropathic pain is frequently seen with other conditions like
diabetes [20], carpal tunnel syndrome, Guillain-Barre syndrome,
cancer [23, 58]multiple sclerosis and kidney disorders [48].
Neuropathic pain presents as a chronic pain condition often
impacting the quality of life in patients suffering from it. Neu-
ropathic pain is classifed into a number of clinical entities, the
most common are Trigeminal neuralgia, Glossopharyngeal neu-
ralgia, Post herpetic neuropathies and Burning mouth syndrome.
Trigeminal neuralgia is an excruciating short lasting, unilateral
facial pain [37] that may be spontaneous or triggered by gentle
[47], innocuous stimuli and separated by pain free intervals of
varying duration [19]. Diagnostic criteria recognize two subsets
of TN: a classical(previously idiopathic or primary) type and a
symptomatic(secondary) TN by the International Headache So-
ciety (IHS) [14]. Classical TN may be related to neurovascular
compression but may be unrelated to recognizable pathology
whereas symptomatic TN that is related to a variety of symptoms
Abstract
Neuropathic pain is initiated by a primary lesion or dysfunction of the nervous system and can be triggered by local trauma
or systemic disorders. Neuropathic pain has a complex presentation which is often a diagnostic challenge and requires a multi-
disciplinary approach in management. Neuropathic pain prevalence is estimated between 1 and 10%, with few studies report-
ing that neuropathic components can be found in 35% of all painful syndromes. Our aim of the study was to evaluate the
most effective treatment modality in management of neuropathic pain. Retrospective analysis was done at the Department of
Oral Medicine and Radiology of Saveetha University hospital from June 2019 - March 2020. A total of 32 patients who were
diagnosed clinically as Trigeminal neuralgia (TN) and Post herpetic neuralgia (PHN) cases were included in the study. Out of
the 32 patients, females (56.2%) were predominant than males (43.7%).Majority of the study patients age group were 60-70
years (37.5%) followed by 50-60 years (31.25%).The study cases consisted of about 96.8% of TN followed by 3.1% of PHN
cases. The left trigeminal nerve (53.13%) was more commonly affected when compared to the right trigeminal (46.88%).The
branches of the trigeminal nerve affected were higher in V3 (62.5%) and V2 (18.75%). The common medical management
of TN involved Carbamazepine (56.25%), combination of Carbamazepine, Gabapentin and Methylcobalamin (28.13%).Only
three patients had undergone surgical management for TN (3.13%). Comparison of medical management in the study group
using VAS pain scores was done. Neuropathic pain requires a proper evidence based management of pain either medically or
surgically. Our study has shown a signifcant reduction in pain in patients under medical treatment. Clinicians hence must use
a systematic approach in management of neuropathic pain with regular follow up.
Keywords: Neuropathic Pain; Post Herpetic Neuralgia; Trigeminal Neuralgia; Vas Pain Scale.