Considering trigeminal neuropathy is a relatively localized form of neuropathic pain, patients with this pain state are considered an ideal group for the investigation of progressive new therapies. 9, 10 Neuropathic trigeminal pain comprises several diagnostic states, including maxillofacial neuropathic pain from trauma, burning mouth syndrome, and atypical odontalgia (phantom tooth pain). 6вЂ“ 8 Neuropathic pain typically presents in the clinic with hyperalgesia, allodynia, spontaneous ectopic discharges, secondary activation, and maintenance of sympathetically maintained pain and regional myofascial pain. It is also well-established that the combined action of glial cells and cytokine modulated inflammation plays an important role in the development and progression of neuropathic pain. 5 Central sensitization provides an explanation for the dimensional increase of the pain field and temporal qualities observed in chronic pain patients. 3, 4 The pathogenesis involves molecular changes (increased sodium channel density, expression of substance P and nerve growth factor), and cellular changes (neuroplasticity and central sensitization). 1, 2 Word descriptor qualities of neuropathic pain that patients report are typically sharp, shooting, burning, electric, or lancinating. Neuropathic pain is one of the most difficult chronic pain conditions to treat and affects approximately 6% of the population and can be caused by any number of events. Keywords: adipose, stem cells, neuropathic, orofacial, trigeminal Antineuropathic pain medication use showed 5/9 subjects reduced their need for medication (gabapentin, P=0.053, Student's t-test).Д¬onclusion: This preliminary open-labeled study showed autologous administration of stem cells for neuropathic trigeminal pain significantly reduced pain intensity at 6 months and is a safe and well tolerated intervention. The mean pain score pre-treatment was 7.5 (SD 1.58) and at 6 months had decreased to 4.3 (SD 3.28), P=0.018, Wilcoxon signed-rank test. Clinical pain outcomes showed that at 6 months, 5/9 subjects had reduced both pain intensity scores and use of antineuropathic medication. There were no systemic or local tissue side effects from the stem cell therapy (n=41 oral and facial injection sites). Lipoaspirate collection ranged from 102вЂ“214 g with total cell numbers injected from 33 million to 162 million cells. Results: Subjects were all female (mean age 55.3 years В± standard deviation 14.67 range 27вЂ“80 years) with pain symptoms lasting from 4 months to 6 years and 5 months.

Outcome measures at 6 months assessed reduction in: i) pain intensity measured by standard numerical rating scale from 0вЂ“10 and ii) daily dosage requirements of antineuropathic pain medication. Following centrifugation, the stromal vascular fraction was resuspended in saline, and then transferred to syringes for local injections into the pain fields. The lipoaspirate was digested with collagenase and washed with saline three times. Methods: Ten subjects with symptoms of neuropathic trigeminal pain underwent liposuction. This preliminary study investigated if: i) injections of autologous MSCs can reduce human neuropathic pain and ii) evaluate the safety of the procedure. Objective: Mesenchymal stem cells (MSCs) have been shown in animal models to attenuate chronic neuropathic pain. E Russell Vickers, 1 Elisabeth Karsten, 2 John Flood, 3 Richard Lilischkis 2ДЎSydney Oral and Maxillofacial Surgery, NSW, Australia 2Regeneus Ltd, Gordon, NSW, Australia 3St Vincents Hospital, Sydney, NSW, Australia

Stem cell treatment for neuropathy