Atypical Facial Pain

Clarkson, Earl; Jung, Eunsu

doi:10.1016/j.cden.2019.08.014

Cited by 12 publications

(15 citation statements)

References 19 publications

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“…In contrast, PIFP, though of necessity within the distribution of the trigeminal nerve, is not confined to the distribution of a particular trigeminal division. It is further defined by its duration of >2 h per day, and of 3 months or longer duration, as well as lack of any other cause [ 1 ] ( Table 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…Notwithstanding, the data that suggests that at least some cases of PIFP are neuropathic in nature remains sparse. Estimates of PIFP prevalence range from 0.03 to 1.0% [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Present treatment of PIFP is non-specific and symptomatic, following the guidelines for management of chronic pain [ 1 ]. Though opiate therapy is mentioned as a possible approach, caution must be exercised because addiction and misuse are major concerns in a chronic condition of unknown etiology.…”

Section: Discussionmentioning

confidence: 99%

“…The two types of non-odontological causes of facial pain that appear to be the most likely to be mistaken one for the other are trigeminal neuralgia (TN) and what used to be called atypical facial pain, but that is now called persistent idiopathic facial pain (PIFP). Confusion between causes of facial pain persists despite the fact that the diagnosis of classical TN should be rather straightforward and not present diagnostic difficulties to the trained clinician [ 1 , 2 , 3 , 4 ]. (The term classical TN is generally restricted to TN caused by neurovascular compression.)…”

Section: Forewordmentioning

confidence: 99%

See 3 more Smart Citations

Chronic Facial Pain: Trigeminal Neuralgia, Persistent Idiopathic Facial Pain, and Myofascial Pain Syndrome—An Evidence-Based Narrative Review and Etiological Hypothesis

Gerwin

2020

IJERPH

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Trigeminal neuralgia (TN), the most common form of severe facial pain, may be confused with an ill-defined persistent idiopathic facial pain (PIFP). Facial pain is reviewed and a detailed discussion of TN and PIFP is presented. A possible cause for PIFP is proposed. (1) Methods: Databases were searched for articles related to facial pain, TN, and PIFP. Relevant articles were selected, and all systematic reviews and meta-analyses were included. (2) Discussion: The lifetime prevalence for TN is approximately 0.3% and for PIFP approximately 0.03%. TN is 15–20 times more common in persons with multiple sclerosis. Most cases of TN are caused by neurovascular compression, but a significant number are secondary to inflammation, tumor or trauma. The cause of PIFP remains unknown. Well-established TN treatment protocols include pharmacotherapy, neurotoxin denervation, peripheral nerve ablation, focused radiation, and microvascular decompression, with high rates of relief and varying degrees of adverse outcomes. No such protocols exist for PIFP. (3) Conclusion: PIFP may be confused with TN, but treatment possibilities differ greatly. Head and neck muscle myofascial pain syndrome is suggested as a possible cause of PIFP, a consideration that could open new approaches to treatment.

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Section: Discussionmentioning

confidence: 99%

“…Notwithstanding, the data that suggests that at least some cases of PIFP are neuropathic in nature remains sparse. Estimates of PIFP prevalence range from 0.03 to 1.0% [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Forewordmentioning

confidence: 99%

See 2 more Smart Citations

Chronic Facial Pain: Trigeminal Neuralgia, Persistent Idiopathic Facial Pain, and Myofascial Pain Syndrome—An Evidence-Based Narrative Review and Etiological Hypothesis

Gerwin

2020

IJERPH

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“…1 Clinical presentation of PIFP is variable, the diagnostic criteria for PIFP are loose and ambiguous, and the pathological mechanism is not clear. [2][3][4][5] As a result, the diagnoses of PIFP are usually regarded as "waste baskets" or exclusive diagnoses. 6 Some patients are diagnosed with PIFP only after a prior misdiagnosis, and insufficient and/or incorrect treatment methods that failed to provide satisfactory pain relief.…”

Section: Introductionmentioning

confidence: 99%

<p>Challenges of Misdiagnosis and Suboptimal Treatment of Persistent Idiopathic Facial Pain and Atypical Odontalgia: A Retrospective Multi-Centric Cross-Sectional Investigation</p>

Xiao

Jiang

Liu³

et al. 2020

JPR

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Purpose To explore the challenges faced in the diagnosis and treatment of atypical odontalgia (AO) and other persistent idiopathic facial pain (PIFP). Patients and Methods This retrospective multi-centric cross-sectional study utilized clinical information (eg, clinical manifestations, history of consultations and treatments prior to correct diagnoses) from patients’ medical records. Their economic parameters were also extracted from medical insurance databases. Each variable collected was statistically analyzed. Differences of variables between AO and other PIFP were statistically tested. Results A total of 394 patients were included in this study. On average, the diagnostic delay was 34.8±14.2 months, a median of 7 consultations were performed prior to a correct diagnosis, and 5 ineffective prescriptions were issued. Patients with AO suffered from longer diagnostic delays than patients with other PIFP (38.4±14.3 months vs 31.6±13.4 months) and were more likely to receive invasive dental treatments (73.3% vs 4.3%). The median total cost of treatment for a single patient before correct diagnosis was 8506.3 yuan. Patients with AO spent more than patients with other PIFP (10,146.5 Yuan vs 3864.0 Yuan). Conclusion Patients with PIFP were frequently misdiagnosed and the length of diagnostic delay was observed to be long. Ineffective medications, unwarranted procedures, and unnecessary economic burden were imposed on the patients. Patients with AO are in a worse situation than patients with other PIFP. As significantly urgent and unsatisfactory results of misdiagnosis of PIFP have been reported in our study, more attention should be paid on the research and education in this field.

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A case of vagal cephalgia as a manifestation of a lung neoplasm—A case report and review of literature

Sanker

Devaragudi

Shariff

et al. 2023

Clinical Case Reports

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Atypical Facial Pain

Cited by 12 publications

References 19 publications

Chronic Facial Pain: Trigeminal Neuralgia, Persistent Idiopathic Facial Pain, and Myofascial Pain Syndrome—An Evidence-Based Narrative Review and Etiological Hypothesis

Chronic Facial Pain: Trigeminal Neuralgia, Persistent Idiopathic Facial Pain, and Myofascial Pain Syndrome—An Evidence-Based Narrative Review and Etiological Hypothesis

<p>Challenges of Misdiagnosis and Suboptimal Treatment of Persistent Idiopathic Facial Pain and Atypical Odontalgia: A Retrospective Multi-Centric Cross-Sectional Investigation</p>

A case of vagal cephalgia as a manifestation of a lung neoplasm—A case report and review of literature

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