Treatment of chronic intractable atypical facial pain using peripheral subcutaneous field stimulation

Introduction: Atypical facial pain (ATFP) is challenging to manage and there are few proven therapies available. We present a case report describing application of peripheral subcutaneous field stimulation (PSFS) to a patient with chronic intractable ATFP which conventional treatment failed to ameliorate. Methods: The patient underwent an uneventful PSFS trial with percutaneous placement of two temporary eight-electrode leads (Medtronic Inc, Minneapolis, MN, USA) placed subdermally over the left mandible. Results: After experiencing excellent pain relief over the next two days, the patient was implanted with permanent leads and rechargeable generator two and a half weeks later and reported sustained pain relief at 12-month follow-up visit. Discussion: Peripheral subcutaneous field stimulation provides an effective treatment option for patients suffering from chronic ATFP who have failed conservative treatment. PSFS may provide pain relief with advantages over conservative treatments and more invasive techniques. Conclusion: Peripheral subcutaneous field stimulation offers an alternative treatment option to select patients with intractable ATFP.