Method: Subjects were consecutive cases treated by an attending/resident team between August 2010 and May 2011. Inclusion criteria were cases presenting to more than two clinic visits and the availability of six-month outcomes. Demographic characteristics included age, gender, ethnicity, medical comorbidities, character, onset, and duration of pain, and response to diagnostic anesthetic blocks. Treatment characteristics included topical medication, systemic medication, and peripheral nerve blocks. Descriptive statistics, linear/logistic regression and bivariate tests compared variables of interest, with a significance threshold of p<0.05.
Result: Male to female ratio was 4: 14 with a mean age of 57 years (95%CI 49.4-64.7). Forty percent (n=7) had three or more medical comorbidities, including depression (n=3) and chronic pain conditions (n=3). Initial mean NRS was of 7/10 (SD±2.3. 95%CI 5.8-8.1). Eight subjects had pain in two or more anatomic intraoral locations. Reported symptom duration in months was an average of 16.5 (95%CI 5-28), range of 1-72. Seven subjects reported heterotropic facial pain, including myalgia (n=2), BMS (n=3) and migraine (n=1). Treatment included systemic medications (antiepileptics, tricyclics) (n=12), topical agents (moisturizer and combination of NSAIDs and antiepileptics) (n=3), and sequential nerve blocks (3% Carbocaine and/or dexamethasone) (n=3). Two subjects received combined therapies (nerve block+ topical (n=1) and systemic medication + topical (n=1)). Six-month global pain relief ranged from 0% to 100%, mean of 46% (95%CI 29%-62.7%). Twelve subjects (66%) reported clinically significant relief at six months. No statistically significant association was found between subject demographics, treatment, and six-month pain outcomes.
Conclusion: Idiopathic persistent facial pain remains a pain diagnosis with challenging treatment. This small pilot cohort reported a significant 6-month pain reduction in a majority of subjects, albeit with no association between subject/pain characteristics and outcomes.