Case of the Month #36: Facial pain by Dr Ameana Khan & Dr Shefali Kadambande

Published: 06/02/2024

Discussion

Ms. W's management commenced with a referral from the neurosurgical team to the specialised facial pain clinic. Examination and history brought to light pain in two specific locations: the maxillary branch of the trigeminal nerve and upper brow pain linked to irritation of the greater occipital nerve. In light of the adverse effects associated with pharmacological therapy, Ms. W was presented with the option of a steroid injection for her greater occipital nerve (GON) and radio-frequency (RF) ablation of the trigeminal nerve as a day case procedure. This emphasises the importance of conducting a comprehensive history and examination for an accurate diagnosis. Notably, Ms. W responded positively to both treatments, enjoying a pain-free year and facilitating a reduction in drug therapy. However, the recurrence of symptoms prompted a repetition of the procedures. This stresses the dynamic nature of pain management and the crucial role of vigilant follow-up care.