Studies of traumatic neuralgia in the maxillofacial region: symptom complexes and response to microsurgery.

Patients with chronic pain following trigeminal nerve injuries were studied before and after microsurgical repairs using the McGill Pain Language Inventory, sensory reflex testing, and assessment of pain relief from nerve blocks. This protocol differentiated four syndrome types that appeared singly or in combination: anesthesia dolorosa (AD), sympathetic mediated pain (SMP), hyperalgesia, and hyperpathia. Trigeminal nerve blocks proved to be good predictors of pain relief from microsurgical treatments. Surgical pain reduction was poor for AD and SMP (14.6% and 20.7%) as compared with hyperalgesia and hyperpathia (60.5% and 56.3%).