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Dr. John S. McDonald specializes in nerve pain, neurogenic pain and neuropathic pain in Cincinnati, Ohio.
Neuropathic pain is pain that arises as a direct consequence of a lesion or a disease affecting the somatosensory system either peripherally or centrally.  It may be continuous or episodic (neuralgic pain or neuralgia) with central and/or peripheral sensitization potentially playing a sustaining role in this disorder.

Continuous or nearly continuous neuropathic pain arising in the face is often idiopathic (of unknown cause).  When arising in the face it has also been termed atypical facial pain (AFP) and when it appears to emanate from one or several teeth is has also been termed atypical odontalgia (AO).  It is characterized as a continuous, or nearly continuous, unilateral, poorly defined, diffuse, aching, boring or burning pain not limited to the distribution of a single cranial nerve.  Attacks may be set off by mechanical stimulation including deep pressure, percussion or chewing.  While often refractory to medical and dental therapies, including analgesic therapy, some patients may respond to antidepressants, anticonvulsants, or both in combination.

Neuralgia, or neuralgic pain, is an episodic form of neuropathic facial pain, or neuralgic pain and is confounding to many practitioners.  Neuralgic pain is characterized by paroxysmal painful attacks of sharp, stabbing, shock-like or burning pain. It may occur spontaneously or be evoked by innocuous stimulus such as light touch to a trigger zone.  Examples of cranial nerve neuralgias include trigeminal neuralgia, glossopharyngeal neuralgia, nervus intermedius and vagal and superior laryngeal neuralgia.  Other painful disorders in the head and neck that carry the moniker neuralgia but are not episodic in nature include occipital neuralgia and post herpetic neuralgia.
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