[Therapy and prophylaxis of facial neuralgias and other forms of facial pain syndromes -- revised recommendations of the German Society of Migraine and Headache]. / Therapie und Prophylaxe von Gesichtsneuralgien und anderen Formen der Gesichtsschmerzen -- Uberarbeitete Empfehlungen der Deutschen Migräne- und Kopfschmerzgesellschaft.

Trigeminal neuralgia and postherpetic neuralgia are the most relevant neuralgiform facial pain syndromes. Trigeminal neuralgia is characterized by lancinating intensive pain attacks of very short duration, triggered by external cues,whereas postherpetic neuralgia consists predominantly of long-lasting burning pain. Sodium channel blocking drugs are first choice in treatment of trigeminal neuralgia, operative procedures encompass microvascular decompression,thermocoagulation and percutaneous retrogasserian glycerol rhizotomy. In the acute stage postherpetic neuralgia is treated antivirally and analgesically, in the chronic stage by tricyclic antidepressive substances. Other pain syndromes described encompass the Tolosa-Hunt-syndrome, cervicogenic headache, craniomandibular dysfunction syndrome, atypical facial pain and rarer syndromes. Therapeutic recommendations are based on evidence based medicine criteria (EBM).

Preemptive analgesia: the prevention of neurogenous orofacial pain.

Chronic neurogenous pain is often an extremely difficult condition to manage. In the orofacial region, trauma from injury or dental procedures may lead to the development of severe neuralgic pains and major distress to the patient. Clinical and experimental evidence suggests that the use of adequate preemptive regional anesthesia, systemic analgesia, and the avoidance of repeated, painful stimuli may reduce the incidence of this problem.

[How to prevent the various neuralgic complaints after operation of maxillary sinus? (author's transl)]. / Wie können neuralgische Beschwerden nach Kieferhöhlenoperationen vermieden werden?

In order to avoid multiple neuralgic complaints after operations of maxillary sinus the following advice for cautions operative procedures is as follows: 1. A vertical incision in the mucosa of the fossa canine behind the eye-tooth instead of the usual horizontal section. 2. A small dorsolateral fenestration in a part of less nervous ramification in the facial bone layer of the antrum of High-more. 3. The limitation of resection of the mucous membrane in pathological areas of the sinus. 450 operations of the maxillary sinus were done in this way, which resulted in a lower rate of postoperative neuralgic complaints. Another advantage was the minimized intraoperative bleeding and the absence of postoperative swelling and haematoma formation of the cheek.