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RESEARCH PRODUCT

Atypical Facial Pain

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Publisher Summary This chapter discusses “atypical facial pain,” which was introduced originally to distinguish trigeminal neuralgia from other facial pain syndromes. The term “atypical facial pain” is also used mostly as a residual category for otherwise unclassifiable pain syndromes in the facial region. The International Headache Society defines atypical facial pain as a persistent facial pain that does not have the characteristics of the cranial neuralgias and is not associated with physical signs or demonstrable organic causes. It is present daily and persists for most or all of the day. It is confined at onset to a limited area on one side of the face and may spread to the upper and lower jaws or other areas of the face or neck. The pain is not associated with sensory loss or other physical signs. Laboratory investigations including X-ray of face and jaws do not demonstrate relevant abnormalities. The etiology and pathogenesis of atypical facial pain are still unclear. The chapter discusses natural course, principles of therapy, practical management, and related syndromes. The discussion on practical management includes tricyclic antidepressants, serotonin-specific reuptake inhibitors, antiepileptic drugs mentioning carbamazepine, and the treatments that are no longer recommended.