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PRESENTATION #8 Case Report | Pain Medicine

TRIGEMINAL NERVE BLOCK IN THE HEAD AND NECK CANCER PATIENT: A CASE OF METASTASES MISATTRIBUTED TO PROCEDURAL COMPLICATIONS

Alan Boiangu, BA, Ochsner Medical Center; Manjunath Shetty, MD; Ochsner Medical Center
Kiruba Vembu, MD, Tulane University; Maged Guirguis, MD, Ochsner Medical Center;
Yashar Eshraghi, MD, Ochsner Medical Center

Presenter: Alan Boiangu, BA
UQ – Ochsner

Trigeminal neuralgia is a relatively common and debilitating disorder characterized by episodic severe pain in the distribution of the trigeminal nerve. The trigeminal nerve block is one modality that has shown efficacy in treating this condition. Many patients benefit greatly from this chronic pain intervention. Although rare, some patients may experience adverse reactions to the block. In the following report, we present a case of a long-term cancer patient who received a trigeminal nerve block for chronic trigeminal neuralgia. Shortly after the procedure, he developed several clinical neurologic deficits which were at first believed to be due to complications of the nerve block. Instead, the patient was found to have metastatic extension of his primary malignancy which produced these deficits. In this report, we seek to show how fundamental knowledge of neuroanatomy as well as thorough familiarity with a procedure and its possible complications can allow clinicians to accurately diagnose the cause of such neurologic symptoms.