Several disorders that cause facial pain can be successfully treated by neurosurgical procedures. It is important to accurately diagnose the disorder and identify the best treatment for each disorder. In the absence of randomized prospective studies, standardized methods of reporting, and standardized outcome criteria, it is difficult to compare the results of various surgical procedures and the different reported series of the same surgical procedure. Nevertheless, several important observations emerge from reviews of the literature and personal experience.
General Observations on Facial Pain
- Accurate diagnosis is required.
- The diagnosis of typical Trigeminal Neuralgia (TGN) is seldom difficult.
- In general, the length of the list of the patients symptoms is directly proportional to the likelihood of treatment failure.
- Medical treatment should be explored before surgery is contemplated.
- There is no successful surgical procedure for treatment of atypical facial pain.
- It is more difficult to treat neuropathic than neuralgic pain.
- Patients with dysesthetic pain seldom respond to ablative surgery.
- There is no single superior treatment for facial pain. The treatment should be individualized. Patients should have access to a broad spectrum of treatment options.
- The results of surgical treatment diminish as facial pain becomes more chronic.
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