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Capsaicin-induced secondary hyperalgesia differences between the trigeminal and spinal innervation.

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Department of Biosciences, Universidade Estadual de Campinas (UNICAMP), Faculdade de Odontologia de Piracicaba (FOP), Piracicaba, Brazil.

This study compared the degree of secondary hyperalgesia and somatosensory threshold changes induced by topical capsaicin between spinal and trigeminal innervation. This crossover clinical trial included 40 healthy individuals in which 0.25 g of 1% capsaicin cream was randomly applied for 45 minutes to a circular area of 2 cm to the skin covering the masseter muscle and forearm in 2 different sessions, separated by at least 24 hours and no more than 72 hours (washout period).

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Schwannomas (SCs) are benign tumors composed of neoplastic Schwann cells and are relatively uncommon intracranially. Although these tumors are frequently associated with neurofibromatosis type 2 (NF2), they may also arise idiopathically, and their pathogenesis remains poorly understood. A 70-year-old Caucasian man presented with a two-month history of vertigo, gait imbalance, and decreased visual acuity in the left eye accompanied by photophobia, nausea, vomiting, and occasional headaches.

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This study reports a rare case of referred pain in the trigeminal nerve distribution caused by entrapment of the greater occipital nerve (GON). Notably, the pain extended to the ipsilateral tongue, an unusual intraoral involvement. GON entrapment can lead to sensitization in secondary nociceptive neurons within the trigeminocervical complex (TCC), which receives signals from both trigeminal and occipital nerves, causing referred facial pain.

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