Facial Pain: An Introduction

While the anatomy may be complex, the correct diagnosis can usually be gleaned from a careful history and physical exam.

Facial pain as opposed to headaches is usually defined as pain in the head anterior to ear and the normal hairline and above the hyoid bone. The area of the temporal regions and the frontal region represent areas of overlap between certain types of headaches and true facial pain. As with most anatomical regions pain in the face is commonly divided into intrinsic and neurogenic pain, with the same therapeutic implications as elsewhere.

 

Common pain syndromes intrinsic to the face include dental pain, sinus pain and pain arising from tear ducts or salivary glands. The most common neurogenic pain syndromes in the face involve branches of the trigeminal nerve resulting from acute herpes zoster, post herpetic neuralgia or idiopathic trigeminal neuralgia. Less common conditions can include temporal arteritis, glossopharyngeal neuralgia, superior laryngeal neuralgia as well as the pain from carotid artery dissection. In many cases a presumptive diagnosis can be reached by means of careful attention to the history and the physical examination. Confirmatory test can include sinus X-Rays or MRI’s or MRI of the brain and facial bones.

 

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