What is deafferentation pain of the trigeminal nerve?

Deafferentation pain is pain that results from damage of some sort to the trigeminal nerve with resulting dense, deep numbness of the face. Many years ago, we tried to treat trigeminal neuralgia by cutting the nerve, which would result in dense numbness of the entire side of the face. It would, at least initially, relieve the sharp shooting episodes of pain. Just like phantom limb pain in a patient who’s an amputee, though, the brain circuitry responsible for pain perception from that side of the face somehow would become active.

Very often a tremendous uncomfortable sort of chronic pain syndrome would develop, involving the side of the face. This kind of pain has been called anesthesia dolorosa, for loss of sensation. Dolorosa refers to painful anesthesia. At this point, there’s no good medication that’s effective. The nerve, which has already been densely injured, can’t be manipulated or interacted with in any way, with radiation therapy or surgical treatment, that's going to affect the deafferentation pain.

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