Anesthesia dolorosa is an uncommon condition resulting from damage to the trigeminal nerve either after surgery or traumatic injury. Anesthesia dolorosa is a deafferentation pain where the patient experiences numbness and loss of sensation to touch but at the same time, patient also has constant pain the within the numb area. The pain is burning and aching.
Anesthesia dolorosa is also called deafferentation pain syndrome. This condition occurs in 2 to 4 percent of people who have undergone trigeminal rhizotomy. There is no specific medical treatment yet known to cure the illness; however, several surgical corrective techniques have been attempted with variable outcome.
What Causes Anesthesia Dolorosa?
Anesthesia dolorosa can develop due to any surgical procedure involving the trigeminal ganglion. Trigeminal nerve is a cranial nerve which innervates the facial region. Trigeminal nerve is responsible for sensation as well as motor function of the face. It is responsible for biting and chewing. It is in fact a surgical complication arising after the surgery of trigeminal nerve ganglion. Anesthesia dolorosa can also develop due to trauma to the trigeminal nerve from an injury other than surgical procedure.
Surgical procedures such as radiofrequency or glycerol therapy or balloon compression all can lead to Anesthesia dolorosa.It is more likely to occur after radiofrequency rhizotomy procedure. Glycerol injection or cutting a part of trigeminal nerve is second reason for Anesthesia dolorosa. All these surgical procedures are done to treat trigeminal neuralgia. The reason which researchers believe is the fibers responsible for touch may get injured during surgery, but the fibers that carrying pain messages may remain intact or there is no damage.
Normally there is overlapping of the nerve fibers in a nerve like trigeminal nerve. But surgery of this nerve may abolish such overlapping. This may cause distortion of signals or message that the trigeminal nerve carries from the brain leading to Anesthesia dolorosa.
Symptoms Of Anesthesia Dolorosa
The characteristic feature of Anesthesia dolorosa is feeling of constant pain in the area of numbness. This pain is described by patients in many ways. Some patients complain of burning pain while some patients refer it as prickling pain. Pain in the numb area is usually on one side of face, the part that is operated. Pain is worse when patient is idle. Patient also complains a feeling of pressure and heaviness in the area.
Anesthesia dolorosa is easily differentiated with trigeminal neuralgia from characteristic pain. The pain in Anesthesia dolorosa is constant and burning or jabbing. But the pain in trigeminal neuralgia is sharp electric like which is intermittent and excruciating in nature.
Treatment Options For Anesthesia Dolorosa
There is no specific medicine yet discovered that will help to cure Anesthesia dolorosa. However, certain medicines are tried with variable response and effect. Medical treatment of Anesthesia dolorosa consists of use of muscle relaxants, anticonvulsant medicines and antidepressant medication. Topical use of anesthetic ointment or anesthetic injection is also tried to reduce pain and numbness. Anesthetic injection is used as a nerve block.
In worst cases surgery may be necessary which may give relief for at least fifty percent of patients. There are few alternative therapies that have been found effective in dealing with Anesthesia dolorosa. For example acupuncture, chiropractic therapy, homeopathy, alternate cold and hot compression, are found beneficial.