Psychogenic facial pain: presentation and treatment.

Abstract

Ninety three patients took part in a two centre double blind controlled clinical trial designed to assess the efficacy of dothiepin (Prothiaden) as compared with placebo and a soft biteguard in the treatment of psychogenic facial pain. The results showed the superiority of dothiepin over placebo in achieving pain relief; 71% of patients were pain free in the dothiepin group at nine weeks compared with 47% in the placebo group. The biteguard conferred no benefit and compliance in its use was poor. Out of 84 patients followed up for 12 months, 68 (81%) became pain free. An adverse life event before development of pain, minimal previous surgical treatment, and freedom from pain at nine weeks were strong prognostic indicators for successful treatment.These results are clear evidence of the efficacy of dothiepin in psychogenic facial pain, though the drug may be needed for up to a year.

Perceived stigma in functional somatic syndromes and comparable medical conditions

“…Patients with TMJP report feeling blamed for their problems when behavioural explanations such as teeth grinding are proposed (Marbach et la, 1988;1990), and given pejorative labels for their condition as psychogenic (Lennon et al, 1989, Feinmann, 1983 or a depressive equivalent (Ford, 1983).…”

Untitled

“…Dois (3,5%) pacientes referiram piora com o calor. Várias publicações têm sugerido que a dor facial atípica seja uma desordem psiquiátrica 6,7,16,23,30 . Depressão é considerado o mais provável diagnóstico 40 .…”

Anxiolytics, Antidepressants and Autogenous training in the therapy of burning mouth syndrome

“…The technique of autogenic training comprises the following: [1] One should isolate from the surroundings -i.e. find a suitable place for the séance, [2] close your eyes, in order to avoid the communication with the outer world, [3] start with suggestion saying: PEACE, SERENE PEACE (once) [4] what follows are the following suggestions: MY RIGHT (LEFT) ARM IS TOTALLY COMFORTABLY HEAVY (six times) [5] PEACE, SERENE PEACE (once) [6] MY RIGHT (LEFT) ARM IS TOTALLY COMFORTABLY HEAVY (six times) [7] PEACE, SERENE PEACE (once) [8] I AM BREATHING (six times) [9] MY HEART IS BEATING PEACEFULLY AND RHYTHMICALLY (six times) [10] PEACE, SERENE PEACE (once) [11] MY STOMACH IS FILLED WITH PLEASANT WARMTH (six times) [12] PEACE, SERENE PEACE (once) [13] MY FOREHEAD IS PLEASANTLY COOL (six times) [14] PEACE, SERENE PEACE (once).…”

“…Due to different distribution of benzodiazepine receptors in the brain, it is possible to use both anxiolytics and hypnotics, which do not have to overlap, which, naturally, depends on the dosage of the drug. There are three groups of anxiolytics: [1] benzodiazepines [2] beta-adrenergic blockers [3] antidepressants with sedating effect.…”

“…Apart from psychical factors, psychosocial factors have significant effects on the emergence of pain on the face and orofacial region.Feinmann and Haris (1) have shown that atypical pain on the face can be associated with a life marked with stressful events and long-lasting problems.…”