Deafferentation facial pain (anesthesia dolorosa) can occur after injury of the first-order trigeminal nerve. It is often debilitating and difficult to treat. The authors report the treatment of anesthesia dolorosa in a 69-year-old man with a 7-year history of pain. The pain occurred after an open resection of a right trigeminal neuroma. After treatment with medications failed, the patient was treated with nucleus caudalis (dorsal root entry zone) lesioning. His facial pain was immediately and completely eliminated. The authors describe the technique of this central neuroablative procedure, and they review the available literature regarding this procedure as well as the current evidence base for neuromodulatory surgeries. After the 1-year follow-up, the authors conclude that the patient attained lasting relief.
Abbreviation used in this paper:DREZ = dorsal root entry zone.
Address correspondence to: Stephen E. Sandwell, M.D., Department of Neurosurgery, University of Rochester, 601 Elmwood Avenue, Box 670, Rochester, New York 14642. email: Stephen_Sandwell@URMC.Rochester.edu.
Please include this information when citing this paper: published online December 14, 2012; DOI: 10.3171/2012.11.JNS121395.
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