13.1.2.3 Painful post-traumatic trigeminal neuropathy

Previously used term:

Anaesthesia dolorosa.

Description:

Unilateral or bilateral facial or oral pain following and caused by trauma to the trigeminal nerve(s), with other symptoms and/or clinical signs of trigeminal nerve dysfunction.

Diagnostic criteria:
  1. Facial and/or oral pain in the distribution(s) of one or both trigeminal nerve(s) and fulfilling criterion C
  2. History of an identifiable traumatic event1 to the trigeminal nerve(s), with clinically evident positive (hyperalgesia, allodynia) and/or negative (hypaesthesia, hypalgesia) signs of trigeminal nerve dysfunction
  3. Evidence of causation demonstrated by both of the following:
    1. pain is localized to the distribution(s) of the trigeminal nerve(s) affected by the traumatic event
    2. pain has developed <6 months after the traumatic event
  4. Not better accounted for by another ICHD-3 diagnosis.
Note:

The traumatic event may be mechanical, chemical, thermal or caused by radiation. Neuroablative procedures for trigeminal neuralgia, aimed at the trigeminal ganglion or nerve root, may result in neuropathic pain involving one or more trigeminal divisions; this should be considered as post-traumatic and coded here.

Comments:

Pain duration ranges widely from paroxysmal to constant, and may be mixed.

Specifically following radiation-induced postganglionic injury, neuropathy may appear after more than 3 months.

13.1.2.3 Painful post-traumatic trigeminal neuropathy following neuroablative procedures aimed at the trigeminal ganglion or nerve root may coexist with 13.1.1 Trigeminal neuralgia if the latter recurs.