5% lidocaine medicated plaster double effect in a case of orofacial localized neuropathic pain

Abstract

Localized neuropathic pain (LNP) is a type of neuropathic pain that is characterized by “consistent and limited area(s) of maximum pain associated with negative or positive sensory signs and/or spontaneous symptoms characteristic of neuropathic pain”. This definition encompasses a huge number of neuropathic orofacial pain syndromes. We present a case report of a patient who was affected with sleep apnea syndrome treated with nocturnal oxygen mask delivery, in whom orofacial LNP hampered the wearing of a mask due to unbearable burning and throbbing pain. The application of 5% lidocaine medicated plaster during the night led to an impressive reduction of both the pain level and the size of the painful area due to the plaster’s pharmacological mechanisms, which were associated with a secondary benefit due to its mechanical protective action. This case report shows how these two factors could be of clinical value and have to be considered more systematically in the treatment of LNP in reducing pain and the size of the painful area.

Keywords:

• trigeminal pain
• localized neuropathic pain
• topical treatment
• 5% lidocaine medicated plaster

Author contributions

Dr Casale has made substantial contributions to the conception and design, acquisition of data, and analysis and interpretation of data; he has been involved in drafting the manuscript, revising it critically for important intellectual content; he has given final approval of the version to be published; and he agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Dr Romanenko has made substantial contributions to conception and design; he has been involved in drafting the manuscript or revising it critically for important intellectual content; he has given final approval of the version to be published; and he agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Dr Allegri has made substantial contributions to the conception and design, and analysis and interpretation of data; he has been involved in drafting the manuscript or revising it critically for important intellectual content; he has given final approval of the version to be published; and he agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Disclosure

Dr Roberto Casale reports no conflicts of interest in this work. In the last 3 years, he has received funds from the following companies: Grunenthal; Merck; Mundipharma; and GB-Pharma. Dr Massimo Allegri reports no conflicts of interest in this work. In the last 3 years, he has received funds from the following companies: Covidien; Grunenthal; Merck; Mundipharma; and Prostrakan. Dr Yuriy Romanenko reports no conflicts of interest in this work.