View source for 7° Clinical case: Brainstem neoplasm in Orofacial pain

{{main menu}}{{ArtBy|autore=Gianni Frisardi}}
'''Abstract:'''The brainstem, a crucial structure connecting the brain to the spinal cord, plays a vital role in sensory, motor, and autonomic functions. This chapter explores a clinical case from 1995 involving a 60-year-old woman, pseudonymously named 'Capsaicin,' who presented with chronic orofacial pain, burning mouth syndrome (BMS), and a history of maxillofacial prosthetic rehabilitation. Initial gnathological and neurological tests did not reveal significant abnormalities, leading to diagnostic uncertainty. However, persistent symptoms, exacerbated by spicy food, raised suspicion of a deeper neurological pathology. The application of the "Coherence Demarcator" model failed to identify a definitive diagnosis, prompting further investigation.

Subsequent MRI scans revealed a brainstem schwannoma, confirming the presence of severe organic neurological damage. Additionally, the involvement of TRPV1 (Transient Receptor Potential Vanilloid 1) channels was highlighted as a possible link between capsaicin-induced pain and neuroinflammation. This case underscores the importance of considering neuro-immune interactions and the limitations of traditional diagnostic frameworks such as the RDC/TMD when addressing complex orofacial pain.

The case emphasizes the need for a more integrated diagnostic approach, one that accounts for rare neurological conditions like brainstem tumors, and suggests that future research focus on TRPV1’s role in pain modulation and neuroinflammation. Capsaicin's paradoxical effect, both as a pain exacerbator and potential therapeutic agent, serves as a reminder of the intricacies in understanding chronic pain conditions.