Nerve block as neuropathic pain treatment for the great auricular nerve neuropathy: A case report

Abstract

Objective/Background The great auricular nerve (GAN) is a major sensory branch of the cervical plexus. Painful great auricular neuropathy causes pain circumscribed to the inferior preauricular region, the jaw angle, the ventral pinna, and the mastoid region. Methods We present a 46‐year‐old woman experiencing facial pain in the bilateral preauricular and infra‐auricular region, constant, of abrasive quality without any other associated symptomatology that is triggered or aggravated with cephalic movements, cervical turn, mandibular movement, and palpation on the affected area. Results Symptomatic treatment with analgesics, anti‐inflammatories, and neuropathic preventive medications was ineffective. However, nerve block anesthetic treatment resulted in complete pain remission. Conclusion Great auricular neuropathy is an uncommon cause of facial pain; our case report is the first bilateral occurrence reported to date. It should be suspected in patients with circumscribed shooting or lancinating paroxysmal pain in the territory of the GAN. It is characterized by the aggravation of pain with cervical movements and complete relief after anesthetic blockade.

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“…When pressure stimulates peripheral blood vessels and nerves, nerves release neuropeptide substance P after noxious stimulation. Substance P leads to pain through two paths of excitatory transmitter and neurogenic medium ( 11 , 12 ). In addition to the above two main symptoms, it is found in clinical practice that patients with the disease may also have accompanying symptoms such as nasal congestion and difficulty in falling asleep.…”